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Flashcards in Pain therapeutics Deck (39):
0

The normal processing of stimuli

nociceptive

1

Only FDA indication for lidocaine 5% patch

post herpetic neuralgia

3

An inbalance of pro-nociceptive and anit-nociceptive stimuli

dysfunctional pain

4

The drug of choice for trigeminal neuralgia

crbamazepine

5

MOA of gabapentin and pregabalin

bind to alpha-2-delta subunit of N-type Ca channels and block them

6

FDA approved used of gabapentin regarding pain

post herpetic neuralgia

7

Abnormal processing of sensory input that is caused by direct damage to the nervous system or persistent stimulaton of the nervous system by another pain source

neuropathic pain

8

Minimum effective dose of gabapentin

600 mg TID

9

FDA approval of pregabalin regarding pain

post herpetic neuralgia, diabetic peripheral neuropathy and fibromyalgia

10

Minimum effective dose of pregabalin

150 mg/day in 2-3 divided doses

11

MOA of katamine

NMDA receptor antagonist

12

MOA of TCAs

5HT/NE reuptake inhibition and Na channel block

14

5 cautions with TCAs

1. BPH
2. arrhythmia (QT prolongation)
3. suicidal idealization
4. hepatic failure
5. renal failure

15

Opioid that is the most useful in neuropathic pain

Methadone

16

4 groups of 1st line agents for neuropathic pain

1. TCAs
2. Gabapentin and pregabalin
3. Lidocaine patch (post herpetic neurophathy)
4. SNRI (diabetic peripheral neuropathy)

17

3 groups of second line agents for neuropathic pain

1. tramadol
2. opioids
3. capsaicin

18

2 opioids that are the most common for a patient to have a true allergy to

codeine and morphine

19

enzyme that metabolizes codeine to morphine

CYP2D6

21

4 opioids that have a risk of serotonin toxicity

1. fentanyl
2. tramadol
3. meperidine
4. methadone

23

the 4 A's of pain

1. Analgesia
2. Adverse effects
3. Activities of daily living
4. Aberrant opioid-related behaviors

25

Opioid that has the worst nausea side effects

Codeine

26

enzyme that metabolizes hydrocodone to hydromophone

CYP2D6

27

Toxic metabolite of meperidine that has a longer half-life and no analgesic action

normeperidine

28

4 C's of addiction

1. Loss of control
2. Continued use despite adverse consequences
3. Compulsion to use
4. Cravings

30

MOA of meperidone

Strong mu agonist and NMDA agonist

31

The gold standard for the treatment of moderate-severe pain

Morphine

32

Neurotoxic metabolite of hydromorphone

H3G

33

Enzyme that catalyzes conversion of oxycodone to noroxycodone, a non-active, non-toxic metabolite

CYP3A4

34

Enzyme that catalyzes conversion of oxycodone to oxymorphone, an active metabolite

CYD2D6

35

Sole route of metabolism of fentanyl

CYP3A4

36

MEQ that is defined as non-opioid naive

>60 mg MEQ for the past 7 days

37

Black box warning for methadone

cardiac toxicity and QT prolongation at >60 mg/day

38

Abnormal behavior developing as a direct consequence of inadaquate pain management

Pseudoaddiction

39

Any drug deviation from the medical plan

aberrant behaviors

40

Patient population to avoid morphine in in order to decrease risk of opioid neurotoxicity

morphine

41

2 opioids that have the lowest risk of neurotoxicity

methadone and fentanyl

42

Damage to solid or hollow organs that is poorly localized and often associated with nausea and diaphoresis

Visceral pain

43

NSAID that has the lowest CV risk

Naproxen

50

Damage to bone, muscle, ligament or skin that is usually well localized

Somatic pain