Pharm Pain

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Cox 1
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Terms in this set (32)
Cox 1
"Good" COX; provides gastric protection, maintenance of renal function, platelet aggregation; inhibition causes gastric ulceration, bleeding tendencies, and renal impairment
COX 2
Bad COX, results in inflammation and pain perception, increases temp, supports renal function/vasodilation, contributes to colon cancer, inhibition results in renal failure
Acetaminophen functions
analgesic, antipyretic; no platelet or anti-inflammatory effects
easier on the liver
acetaminophen mechanism of action
Inhibits prostaglandin synthesis in CNS
acetaminophen max dosage
4 g/24 hrs
Orfirmev
IV, 70% higher concentration CNS than oral, less opioids needed
acetaminophen side effects
acute toxicity- acetylcysteine effective within 24 hours
Bleeding, don't use with alcohol, warfarin, vaccines
Aspirin functions
Analgesic and antipyretic, antiinflammatory, anticoagulant
Aspirin mechanism of action
Inhibits prostaglandin synthesis by cyclooxygenase 1 & 2
aspirin uses
pain, inflammatory conditions (OA, RA, rheumatic fever), cardiac health
aspirin precautionsbleeding disorders, vitamin K deficiency, ARBs, ACEs, alcohol, other NSAIDs, some antibiotics, steroids Do not use in children <15- Reyes syndromeAspirin overdose treatmentdialysis, ventilatory supportSamter's triadAsthma Aspirin sensitivity Nasal polypsNSAIDs functionanalgesic anti-inflammatory antipyretic anti-rhematicNSAIDs mechanism of actionInhibit prostaglandin synthesis by blocking COXNSAIDs contraindicationsallergy to NSAIDs or aspirin, patients with clot history, musculoskeletal disorders (OA, RA)Toradol NSAIDcan use IV for 3 days without kidney injuryIbuprofen issuesbleeding issuesopioid overdose triadcoma, respiratory depression, pinpoint pupilsopioid OD treatmentnaloxone or other opioid antagonist respiratory support and other vital functionsketamine functioninterrupts glutamate function, binds to mu and sigma in higher dosesKetamine adverse effectshallucinations, dizziness, slurred speech, ulcers, kidney problemsMeperidine (Demerol)Opioid Analgesic use short term in ER, administer slowlymeperidine issuescan lead to build up of normeperidine and result in seizures, limit use to <48 hours incompatible with many drugs including barbituratesHow does fentanyl compare to morphine?Fentanyl has 100 times the potency of morphine. Decrease incidence of hypotensiontolerancebody adapts to the drug, higher doses of medication needed to achieve same effectpseudo addictionwhen patients are undertreated for pain, they will behave "like addicts" to get the relief they needaddictionA physiological or psychological dependence on a drugsteroid function for painAntiinflammatory- immunosuppressive, sodium retention, potassium losssteroid pain usesRA, lupus, IBD, allergy/asthma, neoplasmssteroid pain problemslots of issues, always taper- withdrawalsteroid side effectsAdrenal insufficiency, osteoporosis, infection, glucose intolerance, myopathy, fluid imbalances, growth retardation, psychological imbalance, cataracts, glaucoma, peptic ulcers, iatrogenic cushing's syndromes