Non-opioid Analgesics from Small Group Flashcards Preview

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Flashcards in Non-opioid Analgesics from Small Group Deck (7)
1

What are the NSAIDS we discussed? some toxicity about each?

Acetaminophen =20-30% opioid sparing; liver damage at high doses

Non-selective COX1/2 Inibitors = 30-50% opioid sparing and decreased opioid-associated PONV, but has GI effects, bone healing, hypersensitivity, asthma, renal insufficiency, and bleeding

 

Coxibs = COX2 selective but increased incidence of thrombus/stroke/MI

2

What is Gabapentin? How dies it work? Effects? 

Binds to Voltage sensitive calcium channels 

 

20-62% opioid sparing effect

Decreases vomiting, pruritis, and urinary retention from opioids 

Effects - Somnolence, dizziness, HA, balance problems, Peripheral edema, sweating, dry mouth, N/V

3

What is Pregabalin? How does it work? 

Binds to Voltage-sensitive Ca channels 

25-30% opioid sparing effect but unclear if decreased opioid-related adverse effects

 

Effects: somnolence, dizziness, visual disturbances

4

Ketamine as an analgesic: mechanism, opioid-sparing effects, side effects, uses 

NMDA receptor antagonist

30-5% opioid sparing effects - unclear if decreased related adverse effects

Used in low doses for chronic pain management 

Side Effects: Dysphoria, Hallucination, vivid unpleasant dreams, dizziness, blurred vision  etc BUT all are UNLIKELY at LOW doses for which is is used for chronic pain management 

5

What is Clonidine and how is it used? EffectS? 

Centrally actiing Alpha-2 agonist

25% opioid sparing effect and decreases Nausea associated with opioids

 

Side Effects: Intra-op and post-op Hypotension 

6

What is Dexmedetimidine? How does it work/what does it do? Effects?

Centrally acting Alpha2 Agonist

30% opioid sparing effect and decreases Nausea and Itching associated with opioids

Side Effects: Intra-op and Post-op Bradycardia 

7

How is dexamethasone used in pain management? What can it cause?

Glucocorticoid used and has 10% opioid sparing effect

Decreases PONV assoc with opioids

GOOD FOR BONE PAIN especially with Metastases!!! 

Side Effects: Mild hyperglycemia, impaired wound healing and increased infection (although unlikely with single dose)