MOD 2 Orthopedic Pharmacology Acute Pain Management Flashcards
(24 cards)
What type of pain is acute pain typically>
nociceptive
What medication is used for mild pain (1-3)?
non opioids (NSAID or acetaminophen
+/- adjuvant analgesics
What medication is used for moderate pain (4-6)?
immediate release short acting opioids with slow titration
+ non opioid (NAIDs) +/- adjuvant analgesics
What type of medication is used for severe pain (7-10)?
immediate release, short acting opioids with rapid titration
+ non opioid +/- adjuvant analgesics
What do opioids do?
decrease transmission and perception of pain
decrease reaction to pain
What do non opioids do?
decrease sensitization to pain
What is opioid sparing?
using non opioids to decrease the use of opioids
What do non-opioid analgesics do?
effective in treatment of inflammation
What is an example of a non-opioid analgesic?
acetaminophen, NSAIDs
What are side effects of non-opioid analgesics?
dyspepsia and gastric ulceration
What are examples of nonselective COX inhibitors?
ibuprofen and naproxen
What are examples of selective COX-2 inhibitors?
celecoxib and acetaminophen
What do tNSAIDs do?
block platelet aggregation by inhibition of COX-1 TXA synthesis which promotes bleeding
What drugs are anti platelet?
low dose aspirin and clopidogrel (plavix)
What drugs are antithrombotic?
warfarin, apixaban, and dabigatran
Does celecoxib alter platelet function or increase bleeding risk?
no
What are the clinical uses of acetaminophen?
- mild to moderate pain
- at max doses, less effective than tNSAIDs
- no inflammatory response
What are the side effects of acetaminophen?
little risk of side effects on GI tract, platelets, kidneys
hepatotoxicity risk
What are opioids used for?
- acute pain from trauma or surgery
- chronic cancer or acute exacerbations
more effective for mod to severe pain
What do combination agents do?
permit increase in pain control with minimal increase in side effects
What are adverse effects of opioids?
sedation: which can be troublesome in PT sessions
constipation: could be troublesome in patients with spinal cord injury
nausea and vomiting
orthostatic hypotension
insensitivity to CO2
withdrawal
What do anti-inflammatory corticosteroids do?
adjuvant analgesics: treat concurrent symptoms that exacerbate pain
provide independent analgesic activity for some specific pain
What are the benefits of anti-inflammatory corticosteroids?
- anti inflammatory
- helps work with arthritis patients
What are the most common used anti-inflammatory corticosteroid agents?
- prednisone
- methylpednisolone
- dexamethasone
