Therapeutics - Pain 3

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Author:
kyleannkelsey
ID:
282531
Filename:
Therapeutics - Pain 3
Updated:
2014-09-09 15:18:16
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Therapeutics Pain
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Therapeutics - Pain 3
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Therapeutics - Pain 3
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  1. What is Celecoxib commonly used for?
    Rheumatoid arthritis
  2. What are the Non-opioid IV analgesics?
    • APAP (Ofirmev)
    • IBU (Caldolor)
    • Ketorolac (Toradol)
  3. What level of pain are Opioids indicated for?
    • Moderate to severe
    • (cancer, acute pain)
    • When not adequately controlled by an NSAID
  4. Most Opioids provide a similar level of pain relief with the exception of:
    • Codeine
    • Meperidine
    • Propoxyphene
  5. Oral opioids have what OOA?
    • OOA: 45 minutes
    • Peak: 1-2 hours
  6. What route of opioid should be given for severe acute pain?
    IV
  7. What route of opioid should generally be avoided?
    IM
  8. What are the natural opioids?
    Morphine and Codeine
  9. What are the Semi-synthetic opioids?
    • Hydromorphone
    • Hydrocodone
  10. What are the Synthetic opioids?
    • Methadone
    • Fentanyl
    • Meperidine
  11. What is the ratio of IV or oral morphine?
    1:3
  12. What is the parenteral to oral dose ratio for codeine?
    120:200
  13. What is the parenteral to oral dose ratio for Methadone?
    5:10
  14. What is the parenteral to oral dose ration for Hydromorphone?
    1:5
  15. What is the half-life of Methadone?
    12-190 hours
  16. What is the onset of action of morphine10-20 minutes?
  17. What is the OOA for fentanyl?
    7-15 minutes
  18. What is the OOA for Codeine?
    30 minutes
  19. Do opioids have a ceiling effect?
    No
  20. Do NSAIDs have a ceiling effect?
    Yes
  21. Do Opioids have antipyretic or anti-inflammatory activity?
    No
  22. What should you counsel patients on when taking Kadian (Morphine)?
    Long acting = DO NOT CHEW OR CRUSH = Fatal dose
  23. What should you counsel patients on when taking Avinza (Morphine)?
    Long acting = DO NOT CHEW OR CRUSH OR USE WITH ALCOHOL = Fatal dose
  24. What is an appropriate way to take Kadian or Avinza (morphine)
    Swallow capsules whole or take with applesauce
  25. What istehgeneric name for Dilaudid?
    Hydromorphone
  26. What is the opioid naïve dose of Dilaudid (Hydromorphone)?
    0.4 mg IV
  27. What is the dosing of Dilaudad (Hydromorphone) for opioid tolerant patients?
    1 mg IV
  28. What is Exalgo?
    Hydromorphone once daily
  29. What is a usual dose of Exalgo (Hydromorphone QD)?
    8-64 mg/day
  30. What is the OOA of Fentanyl transdermal?
    12-18 hours
  31. Can you apply multiple patches to achieve the correct dose of Fentanyl?
    Yes
  32. What is Actiq?
    Fentanyl lozenge
  33. What is Fentora?
    Fentanyl tablet
  34. What is Onsolis?
    Fentanyl Buccal soluble film
  35. What are the Pros and Cons of Non-transdermal Fentanyl dosage forms?
    More costly but Faster OOA
  36. What is Zohydro?
    Hydrocodone ER capsule (no adjunctive medications)
  37. What is Zohydro (Hydrocodone) indicated for?
    Moderate to Severe chronic pain
  38. How does Codeine compare to other opioids?
    • More dysphoria
    • More constipation
  39. What CYP enzyme converts Codeine to Morphine?
    CYP2D6
  40. What groups have the highest rate (30%) of UM CYP2D6 metabolizers, risking codeine overdose?
    • Saudi Arabians
    • Ethiopians
    • North Africans
  41. How can you dose Codeine in children to minimize overdose?
    Use Ideal Body Weight
  42. Why is Meperidine limited in its use?
    • Given Q2-3 hours
    • CNS toxicity including seizures and coma
  43. What kinetic properties does Methadone have?
    • Non-linear kinetics (2x the dose = more than double the effects)
    • Long half life
    • Accumulates with time
  44. How much acetaminophen can be in combination products?
    NMT 325 mg
  45. What is Tylenol #2?
    • 300 mg APAP
    • 15 mg Codeine

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