Flashcards in Pain treatment lecture 2 Deck (40):
What do Ibuprofen type NSAIDs do?
-COX 1 and COX 2 inhibitor
What amount of Ibuprofen is needed for an analgesic effect?
What amount of ibuprofen is needed for anti-inflammation?
What type of pain do you use ibuprofen for?
-Mild to moderate pain relief
What are the side effects of ibuprofen type NSAIDs?
What amount of ibuprofen is needed for antipyretic action?
What type of people should you be cautious in giving ibuprofen?
-High blood pressure
What are some special properties of ibuprofen like NSAIDs?
How does ketoprofen compare to ibuprofen?
-More potent at lower doses
How does Naproxen (alleve) compare to Ibuprofen?
-Longer lasting and slower acting
Why would you use Celecoxib?
-Lacks GI and anti-clotting action because it is a COX-2 selective antagonist
T/F Celecoxib has been linked with cardiovascular side effects
What are some other NSAID agents? (these are used in arthritis)
What is Indomethacin?
-Potent non-selective NSAID/due to side effects not a common analgesic
What is Meloxicam?
- Preferentially inhibits COX-2 over COX-1 which means less GI problems
What is Diflunisal (Dolobid)?
-Related to salicylates and is supposed to be good for bone pain
What are the possible mechanisms of Acetaminophen?
-Inhibits a COX3 enzyme or serotonin
What are the side effects of acetaminophen?
-Liver toxin in high doses
-Pts with compromised livers should not use
What are the analgesic uses of NSAIDs?
-Mild to moderate pain
What type of somatic pain could you use NSAIDs for?
-Most dental pain
-Most headaches (Tension and congestion types not migraines)
-Most muscle and joint pains
What are some NSAID contraindications?
-Pt on anticoagulants
-Already taking high doses
-Child or adolescent
-History of allergies
What are some anticoagulants?
-Coumadin (Warfarin)/ Pradaxa
-Heart attack/ stroke
What are some signs of a possible ulcer?
-Frequent upset stomach
-Bleeding in stool
-Takes H2 blockers (tagamet)
What are the therapeutic uses of opioid narcotics?
-Somatic and visceral pain
-Mild to severe
-Antitussive (blocks the coughing center)
What are six of the most commonly used narcotics?
What are the more potent forms of narcotics?
What is a less potent narcotic?
Are hydros or oxys more potent?
What type of narcotics are lortab and vicodin?
-Hydrocodone + acetaminophen
What is Meperidine (Demerol)?
-Narcotic analgesic for moderate pain
What is Pentazocine (Talwin)?
-A Narcotic analgesic that is a Mixed agonist/antagonist that treats moderate pain
What is methadone?
-Narcotic analgesic for moderate to strong pain that is used to treat opioid addiction and as an analgesic
What is Buprenorphine?
-Narcotic analgesic for moderate analgesic mixed agonist and antagonist that is used to treat opioid addiction
What is one of the most potent narcotics?
-Fentanyl .1 mg
What are the major opioid agonist side effects?
-Decreased pulmonary reflex
-Constipation/slow bowel movement
-Sedation/additive or synergistic with other CNS depressants
What is the treatment for opioid overdose?
-Inject naloxone (Narcan)
What type of drug is Oxycontin/Percodan?
What are contraindications for opioids?
-History of substance abuse
-Sever constipation or upset stomach
When managing neuropathic pain what is the first line treatment drugs?