-
Mild to Moderate Pain Opiates (3)
- (Codeine, Oxycodone, Hydrocodone)
- - prescribe w/ a non-opioid (reduce the dose of opioids and produce more analgesic)
- - Ex: Tylanol #3, Vicodin
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Ultram (2) S.E (4)
- - Roughly the same efficiacy as Tylenol #3
- - No tolerance, physical dependency, or addiction
- - S.E= Nausea, Constipation, Dizziness, Sedation
-
Opioids (2)
(10) drugs
- - controlled substances
- -
has NO analgesic ceiling, can be administered several routes- Morphine, Fentalyn, Diludad, Percocet - -Demerol, Methadone
- - Avinza, Duramorph, MS contin, Roxanol
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Opioiods for Long acting Chronic pain ATC relief for extended time (4)
- 1. Avinza
- 2. Duramorph
- 3. MS Contin
- 4. Roxanol
-
Demerol (4)
Causes (3)
- - severe pain
- - limited
by HIGH INCIDENCE OF SEIZURES- - Contraindicated
for pts ACUTE PAIN +3 dAYS or who needs LARGER DOSES- -"
pts taking MAO inhibitors - - Causes Hyperpyrexia , delirium, Death
-
Opiates Most common side effects (5)
At risk (3)
- - Constipation
- - nausea
- - Vomitting
- - Respiratory depression
- - Pruritus
- - AT RISK PTS Opioid Naive, Elderly, Lung Disease
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Less Common side effects Opiates (6)
- - Urinary Retention
- - Myoclonus
- - Dizziness
- - Confusion
- - Hallucinations
- * Physical Dependence
-
Adjuvant drugs (1)
(3) mechanisms
- - Enhance the effects of the opioids provide additional pain relief
- - Three mechanisms:1. Enhance effects of oipiods and non-opioids
- 2. Possess anelgesic properties
- 3. Counter act the side effects of other drugs
-
Anticonvulsant (3)
(3) drugs + (2) s.e
- - Affective for NUEROPATHIC PAIN and treatment of headaches
- - Start with a LOW DOSE then increase SLOWLY - Baseline Liver, Renal, and CBC needed
- 1. Gabapentin (Neurontin) :ankle swelling, ataxia (< coordination)2. Tegretol
- 3. Klonpin
-
Antidepressants (1)
(4) Drugs; (4) S.E
- - used for nueropathic pain
- 1. Amitirptyline (Elavil)
- 2. Doxepin (Sinquan)
- 3. Notriptyline (Pamelor)
- 4. Imipramine (Tofranil PM)
- S.E= dry mouth, urinary retention, sedation, orthostatic hypotention
-
Costicosteriods (3)
(2) Drugs
(8) S.E
- - used for ACUTE and CHRONIC CANCER PAIN
- -
pain secondary to SPINAL CORD COMPRESSION- nueropathic pain syndromes - 1. Decadron
- 2. Medrol
- S.E= (high dosage and long term used): hypergylcemia, fluid retention, dyspepsia
- GI bleeding, Impaired healing, muscle wasting, osteoporosis, susceptible to infections
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