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ACJ > Pharmacology _Alagesics > Flashcards

Pharmacology _Alagesics Flashcards

1
Q

Classification of mild pain, moderate pain or severe pain

A
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2
Q

Analgesics depending on Severity of pain:

A
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3
Q

Acetaminophen:
- other names?
- which pain level?
- indications for specific pain, such as

A
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4
Q

Acetaminophen:
- Strength
- Dosage: Adult & Children
- maximum dosage
- Frequency

A

Strength
- Suspension: 160mg/5ml
- Tablet: 325, 500,600

Dosage and Frequency:
- Children: (<12 years old and <40 kgs
○ 10-15mg/kg/dose every 4 to 6hours
○ Maximum daily dose: 75mg/kg/dose
- Adults:
○ 325 - 1000mg /dose every 4 to 6hours
○ Maximum daily dose: 4g/day

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5
Q

NSAIDS is used for which level of pain?

A
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6
Q

***Which conditions that absolute contraindicate NSAIDs?

A

7 pointers

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7
Q

NSAIDs and liver

A
  • severer liver
  • alcoholic cirrhosis
    - Active hepatitis (Little and Falaces)
    - Bleeding disorders - hemophilia A and Von Willebrand disease. (VIII)
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8
Q

Pregnancy and NSAIDs

a) 3rd trimester-……..
b) 1st and 2nd trimester -
- only 3 drugs …. are NTFC
. ……..are considered safe.

A
  • all are contraindicated.
    ASA, diflunisal and flurbiprofen
  • Rest
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9
Q

Pregnancy and NSAIDs

A

a) 3rd trimester - all are contraindicated.
b) 1st and 2nd trimester - ASA, diflunisal and flurbiprofen are NTFC. rest are considered safe.

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10
Q

***Which conditions that relative contraindicate NSAIDs?

A

Limit the use of NSADis in cases of: (Pharma = NTFC)
1. MI and Stroke
a) up to 4 days - NTFC
b) 5 days or more - CI (can be LT as well)

  1. Hypertension (patient on any of the following BAD drugs:
    ACE inhibitors, beta blockers and loop diuretics)
    a) up to 4 days - NTFC
    b) 5 days or more - CI
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11
Q

What is Methotrexate
Manage Patient using Methotrexate to treat Arthritis:

A
  • Methotrexate is indeed a folic acid analog, It works by inhibiting nucleotide synthesis (ADN). This leads to a decrease in DNA synthesis. methotrexate can slow down the growth of rapidly dividing cells.

Pt Management:
- Lower dose of MTX do not need avoid or limit NSAIDs
- Consult physician for any side effects present

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12
Q

Which conditions that absolute contraindicate for ASA only?

A
  1. Children with chickenpox, influenza or flu-like illnesses
  2. Patient on sulfonylureas
  3. Gout
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13
Q

Ibuprofen:
- Strength
- Dosage: Adult & Children
- maximum dosage
- Frequency

A
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14
Q

***Naproxen & Naproxen Sodium
- Strength
- Dosage: Initial dose
- Frequency

A
  • Naproxen: 250, 375, 500mg
  • Nap. Sod: 220, 275, 550 mg
    Suspension: 125 mg/5ml
    Maximum: 1250 - 1375 mg (5 tbsx 250)
    (Initial 500mg; followed by 250mg every 6-8hrs - Nap)
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15
Q

Ibuprofen for kids?
Acetaminophen for kids?
(Dosesage & Frequency? RMD? Strength?)

A

Ibuprofen:
Children (<12 years or <40Kgs) - 10mg/kg/dose every 6 to 8 hours
Maximum daily dosage - 40mg/kg/day
Suspension - 100mg / 5ml, 200mg/ 5ml

Acetaminophen:
Children (<12 years or <40Kgs) - 10-15mg/kg/dose every 4 to 6 hours
Maximum daily dosage - 75mg/kg/day
***Suspension:160mg/5ml

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16
Q

Ketorolac:
- Strength
- Dosage: Adult
- maximum dosage *
- Frequency*

A

Strength :
- Tablet - 10mg

Dosage: Adults - 10mg every 4 to 6 hours (therapy should not go over 5 days: mandatory)

Maximum daily dosage - 40mg/day

17
Q

Dosage of NSAIDs ( memo)

A

Dosage Drug Notes
10 Ketorolac No more than 5 days
25-50 Ketoprofen
50-100 Flubiprofen
200 Celebcoxib QD or BID(S: 100,200)
200-400 Etodolac
200-400 Floctafenine flock-tuh-FEH-neen
250-500 Naproxen
200-600 Ibuprofen

Cach nho:
Maxi: ibuprofen
Min: Ketorolac
Half: Etodolac- Floctafenine
Quarter: Flubiprofen
Naproxen 250 -500 => Ketoprofen: 25-50

18
Q

Frequency of NSAIDs (memo)

A

Q6-8H
Naproxen
Ketoprofen
Ibuprofen for kid

BID
Diflunisal

BID or QD
Celecoxib

19
Q

Acetaminophen vs Ibuprofen:
- Adult dose
- Adult Max daily dosage
- Kid dose
- Kid Max daily dosage
- Frequency:

A
20
Q

Opioid Contraindications

A

(compared to NSAIDs contraindication)
1. severe respiratory disease - severe asthma and severe COPD
2. Severe ulcerative colitis and sever Crohn’s disease
3. Concurrent use of alcohol or other CNS depresssants
4. Drug abuses ( cocaine, heroin)
5. Codeine: not under 12 years
6. Meperidine: MAO inhibitors

21
Q

Specific contraindications of Opioids

A
  1. Meperidine,Tramadol: no MAO inhibitors
  2. Codeine: no under 12 years old
  3. pt with history of tonsillectomy or adenoidectomy, no codeine under 18
22
Q

Heroin vs Morphine

A

Morphine: It is a natural opioid alkaloid and the principal active component of opium.
Heroin: It is a* semi-synthetic opioid* derived** from morphine**. Heroin is created by chemically modifying morphine, and it is a more potent and fast-acting substance.

23
Q

Natural Opioids (Opiates)

A

Morphine, Codeine
(From Opium Poppy)

24
Q
  1. Semi-synthetic opioid from Codeine
  2. Semi-synthetic opioid from Morphine
  3. Semi-synthetic opioid from Thebaine
A
  1. Hydrocodone
  2. Heroin
  3. Oxycodone
25
Q

Synthetic Opioids

A

Fentanyl, Methadone, Meperidine, Tramadol

26
Q

In case of contraindications to both Opioids and NSAIDs, how to treat severe pain?

A

Opioids can be used in this case ( relative contraindication)
Ex: Tramadol

27
Q

Tylenol = ?
Strength of T1? T2? T3? T4?
Frequency?
Daily Max
Dispense: Total tablets max?

A

Codeine + Acetaminophen Q4-6H
T1: Acetaminophen 300mg, Codeine 8mg
T2: Acetaminophen 300mg, Codeine 15mg
Dispense - no more than 36 tablets.
T3: Acetaminophen 300mg, Codeine 30mg
Dispense - no more than 24 tablets.
T4: Acetaminophen 300mg, Codeine 60mg.
Dispense - no more than 24 tablets.

28
Q

Percocet?
Strength of Percocet

A

Acetaminophen 325mg, Oxycodone HCI 2.5mg
Acetaminophen 325mg, Oxycodone HCI 5mg
Acetaminophen 500mg, Oxycodone HCl 5mg

Q4-6H

29
Q

Tramadol
Strength?
Dose? MRD
Frequency

A

tablet: 50 mg- 100mg
dose: 50-100mg
Q4-6H
Max: 400 (8 tablets)

30
Q
A

ACJ (22 decks)

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