Term
|
Definition
| stimulate mu receptor on neurons in the spinal cord and brain to inc pain threshold and dec pain perception |
|
|
Term
|
Definition
| act on peripheral nerves by blocking synthesis of substances that stimulate peripheral nerve endings in damaged tissue to change how a person responds to pain |
|
|
Term
| Rx mild to moderate pain (pain scale 1-3) |
|
Definition
| acetaminophen, asa, NSAIDS |
|
|
Term
| Rx moderate to severe pain (pain scale 4-7) |
|
Definition
| codeine, hydrocodone (usually with nonopioid) |
|
|
Term
| Rx severe pain (pain scale 7-10) |
|
Definition
| morphine, oxycodone, fentanyl |
|
|
Term
|
Definition
| sedation, N/V, ataxia, urinary retention, constipation |
|
|
Term
|
Definition
| respiratory depression (COPD, cor pul, dec respiratory reserve) |
|
|
Term
|
Definition
| closed head injuries and dec pulm fxn |
|
|
Term
|
Definition
| relief of mod to severe pain, CHF, pul edema, or dyspnea, relief of cough, diarrhea |
|
|
Term
|
Definition
| well abs SC, IM, no morphine to neonates, opioid toxicity in breast feeding infants |
|
|
Term
| manifestations of opioid toxicity |
|
Definition
| pin point pupils, respiratory depression, and LOC |
|
|
Term
| antidote for respiratory depression caused by opioid toxicity |
|
Definition
|
|
Term
| withdrawal symptoms of opioids |
|
Definition
| resemble the flu with inc respirations, BP and temperature (use clonidine) |
|
|
Term
| Black Box warning with opioids |
|
Definition
| potential for fatal dose dumping when the opiod adminstered with alcohol |
|
|
Term
| morphine sulfate (MS Contin) |
|
Definition
| mod to severe pain (IV); dec rate then depth of breathing; dose dumping with etoh; respiratory depression, hypotension, urinary retention; crossed BB, antidote of naloxone |
|
|
Term
|
Definition
| DEA C II, c asa DEA C III, with cough DEA C V; mild to moderate pain usually c peripheral analgesic; metabolized to morphine for analgesic effect; metabolized by 2D6 |
|
|
Term
|
Definition
| more effective than codein and mroe potent than oral morphine; DEA C II; controlled release prep for moderate to severe pain |
|
|
Term
|
Definition
| synthetic derivative; acute to mod pain; shorter duration of action than morphine; dysphoria, irritability, seizures; not with MAOI |
|
|
Term
|
Definition
| mixed antagonist at mu receptor and agonist at kappa receptor; mild to mod analgesic; produce analgesia with less respiratory depression and less abuse potential than pure agonists; sedation, not with pure opioid agonist |
|
|
Term
|
Definition
| PO antagonize opioid induced respiratory depression; reverse opoid effects in OD; short acting; titrate carefully to reverse OD but not too much or pain will return |
|
|
Term
| Naltrexone (Trexan, ReVia) |
|
Definition
| narcotic antagonist; prevent readdiction in narcotic addicts; injection for alcoholics and appetite suppreseant in obestiy; no euphoria with narcotic; GI sx, hepatocellular damage rare |
|
|
Term
|
Definition
| NSAID; alternate to morphine or meperidine; strong analgesic; indicated only for short term management of mod severe acute pain--> PUD; CI in pts at risk fo bleeding and labor |
|
|
Term
|
Definition
| centrally acting synthetic analgesic not DEA controlled; moderate pain; MOA unknown; dependence, withdrawal sx; severe serotonin syndrome; dizziness/vertigo, NVC, HA, somnolence |
|
|
Term
| non opiod analgesics general info |
|
Definition
| with high doses, ASA, APAP, and NSAIDs all reeach max analgesic effect |
|
|
Term
|
Definition
| irreversible inhibition of COX enzymes to inhibit prostaglandin synthesis and thromboxane |
|
|
Term
|
Definition
| confusion, tinnitus, hypoglycemia, abn bleeding time, ductus arterosis, GI upset, NV, sodium and water retention --> edema |
|
|
Term
| aspirin (ASA) indications |
|
Definition
| DOC for most articular and MS disorders; first line for RA & OA |
|
|
Term
|
Definition
| analgesic, antipyresis, anti-inflammatory (RA and OA), prevents platelet aggregation |
|
|
Term
|
Definition
| prolonged labor, Reye syndrome in children, inc potential for bleeding and ulcers; interaction with methotrexate |
|
|
Term
|
Definition
| asa toxicity characterized by dizziness, confusion, neuromuscular changes, vomiting, tinnitus, dec hearing, HA, GI upset |
|
|
Term
|
Definition
| non selective vs COX-2 inhibitors (Celebrex and Mobic); inhibit formation of COX |
|
|
Term
|
Definition
| dysmenorrhea, fever, pain, knflammation, temp platelet aggregation |
|
|
Term
|
Definition
| rapidly and almost completely absorbed. highly protein bound and eliminated via hepatic biotransformation |
|
|
Term
|
Definition
| same as ASA; weak acids that concentrate in tissues with acidic environ; cross allergy with asa |
|
|
Term
|
Definition
| CV problems (COX has cardioprotective effect on heart) |
|
|
Term
|
Definition
| GI bleeding, poor renal fxn, asa allergy |
|
|
Term
|
Definition
| effectiveness by the ACE inhibitors and BB- no major interactions |
|
|
Term
| Indomethacin sodium trihydrate (Indocin IV) |
|
Definition
| cause more SE than other NSAIDS; closure of PDA, severe arthritis; same as ASA but reversible; inc gastric ulcers, nephrotoxicity; cross allergy to asa; interfere with diuretics |
|
|
Term
|
Definition
| mild to mod pain, fever, inflammatory conditions (RA); same SE as asa but reversible; inc risk gastric ulcers, nephrotoxicity; cross allergy to asa; interfere c diuretic effects |
|
|
Term
| Naproxen (Naprosyn) OTC Aleve |
|
Definition
| longer acting than ibuprofin so BID; NSAID; same SE as asa but reversible; inc risk gastric ulcers, nephrotoxicity; cross allergy c asa; interfere c diuretics |
|
|
Term
|
Definition
| NSAID; equal to morphine in analgesic potency; short term management of pain; same SE as asa but reversible; BB warn of peptic ulcers and renal failure; CI for L&D |
|
|
Term
|
Definition
| NSAID; inflammation and pain of OA & RA c fewer ulcers; selective COX-2 inhibitor; less GI upset than other NSAIDS; BB warn of GI ulceration and perforation |
|
|
Term
| Acetaminophen (APAP) or Tyelenol |
|
Definition
| DOC for OA; NO anti inflammatory effect; MOA unclear; hepatic injury and leading cause of liver transplant; cross BBB |
|
|
Term
| Antidote to APAP toxicity |
|
Definition
| N-acetylcysteine (Mucomyst) |
|
|
Term
|
Definition
| stops destruction of the joint and may reverse the damage; start w/in 3 mo of dx |
|
|
Term
|
Definition
| immunosuppressant; most widely used DMARD; RA and CA; MOA unknown; methotrexate-induced lung dx; warning that deaths have occurred so use only after failure of other agents; PG X and reduces folic acid |
|
|
Term
| Classes of antirheumatics |
|
Definition
| Immunosuppresants, biologic response modifiers, TNF inhibitors |
|
|
Term
|
Definition
| IV Tx of RA c methotrexate first line and Crohn's; monoclonal antibody binds TNF; inc risk of infection, infusion injection |
|
|
Term
|
Definition
| high levels of uric acid either from hypoexcretion or excessive production or both; uric acid precipitation in joints; commonly affects big toe |
|
|
Term
| generalized tx for acute attack of gout |
|
Definition
| intra-articular corticosteroids, NSAIDS, colchicine |
|
|
Term
|
Definition
| first choice for acute gouty arthritis; suppresses inflammation; impaired renal fx, GI ulcers, fluid retention, CV events |
|
|
Term
|
Definition
| pain in acute gouty attacks; MOA unknown; stop tx when diarrhea occurs; teratogen, N/V dehydration |
|
|
Term
|
Definition
| DOC for hyperuricemia in pts who are hypoexcreters; uricosuric so it inhibits the reabsorption and inc urinary excretion; STAY HYDRATED; anorexia, N/V, worsening of gout |
|
|
Term
|
Definition
| tx of hyperuricemia in pts who are excessive producer of uric acid; blocks the xanthine oxidase enzyme responsible for formation of uric acid; preferred in impaired renal fx; must stay hydrated; GI upset and skin rashes; CI in other xanthine oxidase drugs |
|
|
Term
|
Definition
| chronic management of hyperuricemia; xanthine oxidase inhibitor; liver fxn abnormalities, nausea, rash |
|
|
Term
| treatment for tension h/a |
|
Definition
|
|
Term
|
Definition
| serotonin 5HT receptor agnonists; acute tx of cluster H/A and acute migraine prophylaxis; cranial vessel constrictiona nd inhibitition of proinflammatory neuropeptides; elevates BP, coronary vasospasms, tingling, MAOI inc effect, PG C; CI IV and CAD pts |
|
|
Term
|
Definition
| preferred method for prophylaxis of migrain; MOA unclear |
|
|
