Flashcards in Drugs Deck (23)
Anticoagulant used to prevent DVT and PE
40mg prophylactic dose
Always given at 6pm
What is lorazepam used for?
Lung cancer, breathlessness and agitation
Pro-kinetic increases peristalsis
Avoid in complete obstruction risk of perforation
How do you calculate the PRN dose?
Total regular dose divided by 6
What's simple linctus used for?
What's zopiclone used for?
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)
What are the symptoms for being opioid toxic?
Eventual respiratory depression
What are NSAIDs used for?
What are the side effects of NSAIDs?
Impaired renal function
What must be prescribed alongside a NSAID?
Prophylaxis PPI (Lansoprazole)
What PRN is used when a patient is on step 3 analgesics?
What must be prescribed alongside codeine?
Sodium docusate- softener + stimulant
What are immediate release morphines?
Onset 30 mins lasts 4 hrs
What's a modified release morphine?
Onset 4 hrs lasts 12hrs
What are the side-effects of opioids?
Nausea + vomiting (haloperidol/metochlopramide for delayed gastric emptying)
Dry mouth (oral balance gel)
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
What are the alternative opioids used?
Immediate release- OxyNorm (capsules and liquid injection)
Modified release- Oxycontin tablets
Transdermal patch lasts 72 hrs
16-24 hrs to reach peak plasma levels
Increased body temp will increase drug delivery
What drugs are used for subcutaneous pain relief?
Diamorphine (x3 stringer than oral morphine)
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
What are co-analgesics used?
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)
What is used for bone pain?
Widespread pain- bisphosphonates
Localised pain- radiotherapy
Multiple metastases- radio nuclides
What is used for neuropathic pain?
Nerve block- intercostal (local)/epidural (regional)