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Flashcards in Drugs Deck (23)
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1

What's enoxaparin?

LMWH
Anticoagulant used to prevent DVT and PE
40mg prophylactic dose
Always given at 6pm

2

What is lorazepam used for?

Lung cancer, breathlessness and agitation

3

What's metoclopramide?

Anti-emetic
Pro-kinetic increases peristalsis
Avoid in complete obstruction risk of perforation

4

How do you calculate the PRN dose?

Total regular dose divided by 6

5

What's simple linctus used for?

Cough

6

What's zopiclone used for?

Sleeping pill

7

What are the step 1, 2 and 3 analgesics?

Step 1- Non-opioids (paracetamol)
Step 2- Weak opioids (codeine/tramadol)
Step 3- Strong opioids (morphine/fentanyl patches)

8

What are the symptoms for being opioid toxic?

Drowsy
Confused
Hallucinating
Pinpoint pupils
Myoclonic jerks
Eventual respiratory depression

9

What are NSAIDs used for?

Inflammation
Raised ICP
Bony pain

10

What are the side effects of NSAIDs?

Impaired renal function
Bleeding
Ulcers

11

What must be prescribed alongside a NSAID?

Prophylaxis PPI (Lansoprazole)

12

What PRN is used when a patient is on step 3 analgesics?

Oramorph/sevredol

13

What must be prescribed alongside codeine?

Laxative
SENNA- stimulating
Sodium docusate- softener + stimulant

14

What are immediate release morphines?

Oramorph (liquid)
Sevredol (tablet)
Onset 30 mins lasts 4 hrs

15

What's a modified release morphine?

Zomorph
Onset 4 hrs lasts 12hrs

16

What are the side-effects of opioids?

Nausea + vomiting (haloperidol/metochlopramide for delayed gastric emptying)
Unsteadiness
Drowsiness
Constipation
Dry mouth (oral balance gel)
Urinary retention
Hallucinations
Sweating
Myoclonus
Rash

17

When are alternative stronger opioids used?

Patients are intolerant of morphine
Opioid responsive pain that doesn't get relief from morphine
Switching can be associated with reduction in side effects and improved pain relief

18

What are the alternative opioids used?

Oxycodone
Immediate release- OxyNorm (capsules and liquid injection)
Modified release- Oxycontin tablets
Fentanyl
Transdermal patch lasts 72 hrs
16-24 hrs to reach peak plasma levels
Increased body temp will increase drug delivery

19

What drugs are used for subcutaneous pain relief?

Diamorphine (x3 stringer than oral morphine)
Morphine
Oxycodone
May be a PRN or via a CSCI using a syringe driver and may be used in conjunction with other medication in the same syringe

20

What are co-analgesics used?

Corticosteroids- Dexamethasone
Anti-depressants- Amitriptyline (used for nerve pain)
Anti-convulsants- Gabapentin (younger patients, interrupts nervous pathway
Anti-spasmodics- Hyoscine Butyl bromide (Buscopan, good sub-cut not orally)
Muscle relaxants- benzodiazepines (lorazepam)
Bisphosphonates- Pamidronate (bony pain)

21

What is used for bone pain?

Widespread pain- bisphosphonates
Localised pain- radiotherapy
Multiple metastases- radio nuclides

22

What is used for neuropathic pain?

Drugs- corticosteroids/anticonvulsant
Nerve block- intercostal (local)/epidural (regional)

23

Which anticipatory medications are used?

Morphine surface injection (uncontrolled pain)
Haloperidol injection (anti-emetic, agitation)
Hyoscine N Butylbromide injection (buscopan) (secretions)
Midazolam injection- (breathlessness, anxiety)