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Pharm Midterm 2 > Pain > Flashcards

Flashcards in Pain Deck (42):
1

What is nociceptive pain

Noxious stimuli
Just your regular old pain

2

What is inflammatory pain

Tissue damage present
Still normal

3

What is neuropathic pain

Damage to nervous system
Pathological

4

What is functional pain

Abnormal response to normal stimuli

5

What is chronic malignant pain

Associated with progressive diseases

6

What is chronic non-malignant pain

Not life threatening disease but >6mos past healing period

7

What kind of pain is acute pain

Nociceptive or Neuropathic

8

Tx of mild pain

Non-opiod + adjuvant

9

Tx moderate pain

Medium opioid + Non-opiod + adjuvant

10

Tx severe pain

Strong opioid + Non-opiod + adjuvant

11

What are the Non-opiods

Acetaminophen
NSAIDs

12

What is the first line for low back pain and OA

Acetaminophen

13

What is a major AE of Acetaminophen

Hepatotoxicity

14

When are NSAIDs given

Inflammation pain
RA, Gout

15

Do Non-opioids have a ceiling

Yes

16

Moderate pain opioids (4-6)

Codeine
Hydrocodone
Oxycodone
Meperidine
Propoxyphene (cept no)
Tramadol

17

Severe pain opioids (7-10)

Morphine
Hydromorphone
Oxymorphone
Levorphanol
Fentanyl/Sufentanil
Methadone

18

Which Opioids have ceiling

Mixed

19

What happens when you go over ceiling

Increased chance of AE

20

What are the Mixed

Pentazocine
Butorphanol
Nalbuphine
Buprenorphine

21

How is Pruritis/Urticaria managed

Hydroxyzine
Diphenhydramine

22

How is constipation managed

Senna + Docusate
Laxative + Softener

23

Why are bulk formers not good for pts with advanced disease

Needs lots of fluid intake

24

How is N/V managed

May become tolerant
Hydroxyzine
Metoclopramide
Prochlorperazine

25

How is Sedation managed

Tolerance
Methylphenidate

26

How is Resp Depression managed

Naloxone

27

Which opioid is not given via routine dosing

Meperidine
Mixed (due to withdrawal and psych)

28

How does routine dosing work

Give till comfortable and give again before the effect wears off

29

What is the rescue dose

10-20% of daily total requirement - For breakthrough pain (Fentanyl lollipop)

30

When are TCAs given as adjuvants

Neuropathic pain
Diabetic neuropathy
Post-herpetic neuralgia
Fibromyalgia

31

What are the TCA AE

Constipation
Xerostomia
Blurred vision
Decreased cognition
Tachy
Orthostatic hypotention --> falls
Weight gain and sedation

32

Which TCAs are secondary amines

Desipramine
Nortriptyline

33

Which TCAs are tertiary amines

Imipramine
Amitriptyline

34

Which TCAs have less AEs

Secondary

35

How do TCAs work

NE/5-HT reup inhibitor
Descending inhibition of pain

36

What are the SNRIs

Venlafaxine
Duloxetine

37

DOC trigeminal neuralgia pain

Carbamazepine

38

Anticonvulsant for postherpetic neuralgia and diabetic neuropathy

Gabapentin

39

Anticonvulsant for postherpetic neuralgia and diabetic neuropathy and fibromyalgia

Pregablin

40

Anticonvulsant for migraine prophylaxis

Valproate
Topiramate

41

DOC glucocorticoid

Dexamethasone

42

Misc Adjuvants

Hydroxyzine
Clonidine
Lidocaine
Capsaicin
Caffeine