vitohuxo's version from 2016-03-17 02:12


Question Answer
joint commission standard requires that pain be treated same manner asvital signs
addition of non-opiods to a regimen can often reduce the total opiod dose
low back pain what can help?apap and nsaids, amitriptyline or duloxetine. if severe then tramadol or opiods lowest effective dose shortest time required.
low back pain what not helpful?steroids have not been found to be helpful! muscle relaxants efficacy questionable.
physiologically adaptedphysical dependence. will suffer withdrawals.
addictionstrong desire or compulsion to take the drug despite harm-drug seeking behavior
psuedo addictionanxious about running out of drug and may have used too quickly- may be due to poorly controlled pain.
tolerancehigh dose to produce same analgesic response
opiod hyperalgesiachronic opiod use can worsen pain sensitivity. switch opiod or wean off to other types analgesics.
two types of pain=nociceptive pain (physical truama to organ) or neuropathic (damage to a nerve)
nociceptive pain is one of two typessomatic= skin, muscles, bones, joints (musculoskeletal) OR visceral (internal organs)
acetaminophen does whatreduces pain and fever but does not provide a sig anti-inflamm effect nor does it inhibit thromboxane (platelets)
antidote for APAPn-acetylcysteine (NAC, Mucomyst) PO and Acetadote (IV) = more costly. restores intracellular glutathione. administer immediately!!!!!
mucomyst dose overdose140mg/kg loading dose then 70mg/kg every 4 hours for 17 doses!!!!
APAP dosing max less than 4000mg daily and max 325 mg per dosing unit in combo products per FDA. avoid writing APAP on labels =)
Offirmev injection APAPused inpatient to enable decreased opiod doses and when other routes not feasible
can cause severe skin rash APAP, NSAIDS
iv APAP doses should be preparedin the pharmacy and order in mg, not mLs!!!!!!!!!!!!!!!!!
COX 2produces prostaglandins involved in pain, inflammation, and fever.
COX 1thromboxane involved in platelet aggregation. also protects gastric mucosa. ASA irreversible blocks so why better than NSAIDS CV
MedGuide requiredNSAIDS
use of NSAIDS CI in perioperative pain in the setting of CABG surgery. before, during, and after surgery
reyes syndromealmost always associated with a previous viral infection such as influenza (flu), cold, or chicken pox. Scientists do know that Reye's Syndrome is not contagious and the cause is unknown.Abnormal accumulations of fat begin to develop in the liver and other organs of the body, along with a severe increase of pressure in the brain. Unless diagnosed and treated successfully, death is common, often within a few days, and even a few hours
durlazaRX aspirin EC capsule 162.5mg once daily
salicylate overdose can causetinnitus
caldoloriv injection ibuprofen
dylojectdiclofenac iv
arthrotecdiclofenac + misoprostol. no use women childbearing age unless capable complying contraceptive measures. misoprostol can terminate pregnancy, is used to replace the gut protective prostaglandin to decrease risk GI damage
indocinindomethacin....GI toxicity
avoid in psych conditions (high risk CNS SE)indomethacin
nsaid known severe skin rash...used when other nsaids have failedpiroxicam
toradol/ sprixketorolac. always start iv, im, or nasal spray and continue with oral if neccessary. 5 days total max treatment! can cause severe adverse events gi bleeding, acute renal failure, liver failure. CI advanced renal impairment
sulfonamide allergy and celebrexallergy to bactim pry ok take celebrex, BUT be aware interaction still there and can happen!!!!!! Says CI in book if sulfonamide allergy
mobicmeloxicam- cox 2 selective...higher CV risk lower GI
nabumetonecox 2 selective ...higher CV risk, lower GI
if taking ASA and ibuprofen then take ASA1 hr before or 8 hours after ibuprofen
can raise blood pressureNSAIDS