Pain Managment Flashcards
Exam 3 (29 cards)
Nociceptive Pain
Normal nerve activity responding to tissue-damaging stimuli
Acute or chronic
Ex: arthritis
Neuropathic Pain
Dysfunction in nervous system or damage to nerve
Ex: DM
What drugs are non-opioid meds?
Acetaminophen
NSAIDS:
Ibuprofen- IV, PO
Ketorolac- IV, IM
Meloxicam- PO
Diclofenac- topical
Acetaminophen- MOA?
Analgesic and Antipyretic
No anti-inflammatory properties
Acetaminophen- side effects?
BBW: Hepatotoxicity, med errors
Check other OTC meds for content
Increased risk hepatotoxicity w/ alcohol use
Acetaminophen- max dose?
4,000mg / day
NSAIDs- MOA?
COX-1 inhibition -> decreased GI protection, decreased platelet aggregation
COX2 inhibition -> produce prostaglandins to help w/ inflammation
COX1 & COX2 inhibition -> decreased prostaglandins
NSAIDs- side effects?
MI / stroke
GI bleeds
Ketorolac: short-term, 5days
Renal dysfunction
Impaired platelet activity
Bleeding
Do not combine NSAIDs together
NSAIDs- max dose?
3,200mg / day
What drugs are opioids?
Morphine
Oxycodone
Hydromorphone
Fentanyl
Tramadol
Tolerance vs. Dependence?
Tolerance:
Reduced response after repeated administration -> adaptation
Physical Dependence:
Results from adaptation, manifested w/ withdrawal s/sx w/ abrupt d/c
Psychological dependence:
Impaired control of drug use based on rewards of drug, or psychological distress by drugs absence
Opioid Tolerant:
> 1week of 60mg/day morphine PO
Opioids- side effects?
Constipation
Sedation/dizziness
Nausea/Vomiting
Itching
CNS depression
Dependence/tolerance
Risk of diversion
BBW:
Addiction
Abuse
Missues
Respiratory depression
Opioids- main differences?
Morphine- IV, PO, Not given w/ renal failure d/t accumulation, itching
Oxycodone- PO, CYP interactions
Hydromorphone- IV, PO, 7x stronger than IV morphine
Fentanyl- IV, patch, PO, 100-300stronger than IV morphine-> mcg dosing
Tramadol- PO, 5-10x weaker than IV morphine, risk of serotonin syndrome & seizures
Naloxone- indications?
Opioid reversal, overdose
Naloxone- MOA?
Opioid antagonist, displaces opioid that may be bound
Gabapentin- indications?
Neuropathic pain
Ex: neuropathy, fibromyalgia, seizures
Gabapentin- MOA?
Modulate excitatory NT release -> control nociception
Gabapentin- side effects?
Sedation
CNS/RR depression
Pregabalin- indications?
Neuropathic pain
Ex: postherpetic neuralgia, fibromyalgia, seizures
Pregabalin- MOA?
Modulate excitatory NT release -> control nociception
Pregabalin- side effects?
Weight gain
Peripheral edema
Sedation
Anticholinergic-> dry mouth, constipation, urinary retention
CNS/RR depression
Schedule 5 controlled substance
Triptans- indication?
Migraines
Cluster headaches
(Sumatriptan)
Sumatriptan- MOA?
Selective serotonin receptor agonist on blood vessels -> vasoconstriction -> decreased inflammation
Sumatriptan- side effects?
Decreased birth control effectiveness
Dizziness/vertigo
Tightness/tingling/temp. changes
Use > 10days / month
