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7586 Week 2/3 Drug-Specific Notes

Terms in this set (18)

aspirin
- useful in the treatment of osteoarthritis, minor aches and pains, mild-to-moderate pain from musculoskeletal conditions and fever
- anti-inflammatory
- Reye's Syndrome potential
acetaminophen
- useful for relieving mild-to-moderate pain of non-visceral origin
- preferred first-line treatment of osteoarthritis
- does NOT have anti-inflammatory properties
- preferred for self-care during pregnancy
NSAIDS
- good for pain associated with headache, the common cold, toothache, muscle ache, backache, arthritis, bone pain, menstrual cramps, and mild-to-moderate pain of non-visceral origin
- provides short-term reversible platelet inhibition
celecoxib
- contraindicated in patients with a sulfa allergy
adjuvants (co-analgesics)
- mainstay of treatment for neuropathic pain
- also used to augment or enhance other pain regimens
- may have a direct or indirect effect on pain
- good for neuropathic pain
anticonvulsants
- good for neuropathic pain
antidepressants
- good for neuropathic pain
corticosteroids
- particularly beneficial in pain associated with swelling and inflammation (i.e., cancer)
antihistamines
- caution use with opioids (over-sedation)
capsaicin
- requires consistent application many times per day for several days to see benefit
- not for PRN use
- do not apply with heat
- counsel patients to wash hands after applications (don't touch eyes)
lidocaine patch
- 12 hours on, 12 hours off
- need patch-free time to prevent tachyphylaxis
opioids (general)
- used for moderate-to-severe pain and cancer-related chronic pain
- causes pruritus, sedation, respiratory depression, and constipation
- tolerance is acquired to many side effects except constipation
- for chronic pain, opioids should be administered ATC with PRN opioids for BTP
- no ceiling effect (can titrate dose until side effects are intolerable)
tramadol
- contraindicated for use within 14 days of an MAOI
- not a true opioid, so it does have a ceiling
codeine
- avoid if possible (especially in children and breastfeeding mothers)
hydrocodone
- metabolized to hydromorphone
- combination products are the most frequently used in effort to deter abuse
fentanyl
- Caution: mcg vs. mg
- takes 12-24 hours for onset
- never use in opiate-naive patients
- do not use patch for acute pain
- lollipop/lozenge not for opiate-naive individuals
meperidine
- contraindicated for use within 14 days of an MAOI
- metabolized to normeperidine which is neurotoxic and can result in seizures
methadone
- many drug interactions due to CYP450 interactions
- consult a pain management expert
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