Non-opioid Analgesics from Small Group Flashcards Preview

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

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


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


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


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 


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 


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 


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)