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Flashcards in pain management Deck (45)
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31

list the 2 dissociative agents

ketamine, tramadol

32

what are the cardiovascular side effects of ketamin

sympathomimetics effects
-increased heart rate and blood pressure
-positive inotropic, which increases cardiac workload and myocardial oxygen consumption

33

what are some side effects of ketamine

-potential to increase cerebral metabolic activity
-may increase cerebral blood flow and intracranial pressure
-contraindicated for patients with intracranial disease or high intracranial pressue

34

what is ketamine

a good somatic analgesia but poor visceral analgesia, not popular can cause rough recoveries, hallucinations, not good in humane medicine either

35

which drug has a proposed dual mechanism as an opioid and as a non-opioid

tramadol

36

what does being a proposed opioid for tramadol mean

it suggest that it selectively interacts with mu receptors and induces analgesia

37

what does being a proposed non - opioid for tramadol mean

it suggests that it inhibits central norepinephrine and serotonin reuptake and blocks nociceptive impulses at the spinal level

38

which patients should we use caution in for NSAIDs

renal insufficiency, hypotensive/hypovolemia, peri-operative use, avoid NSAIDs for patients receiving steroids

39

why should a patient receiving steroids not be given an NSAID

because it will further decrease the production of protective gastric secretions and cause a severe GI ulcer

40

why should NSAIDs be given with food

to avoid GI irritations

41

what are the side effects of NSAIDs

gastric irritation/ulercation, decreased renal blood flow (may damage the kidneys), decreased platelet activity (may decrease level of thromboxane(used for platelet aggregation)

42

what are the 3 generations of NSAIDs

COX -1 preferential
COX-2 preferential
COX-2 selective

43

what does the COX-1 preferential do? example?

it has a higher affinity and blocks COX-1 enzyme
Aspirin

44

what does the COX-2 preferential do? examples (4)?

it has a higher affinity and blocks COX-2 enzyme
Carprofen, Meloxicam, Ketoprofen, Etodolac

45

what does COX-2 selective do? examples (3)?

it may block the negative side effects of COX-2 with minimal effect on COX-1
Deracoxib, Robenacoxib, Firocoxib