Therapeutics - Pain 4

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kyleannkelsey
ID:
282532
Filename:
Therapeutics - Pain 4
Updated:
2014-09-09 15:19:09
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Therapeutics Pain
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Therapeutics - Pain 4
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Therapeutics - Pain 4
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  1. What is Tylenol #3?
    • 300 mg APAP
    • 30 mg Codeine
  2. What is Tylenol #4?
    • 300 mg APAP
    • 60 mg Codeine
  3. What group of patients is Transdermal buprenorphine (Butrans) a good choice for?
    Elderly
  4. What is the brand name for Transdermal buprenorphine?
    Butrans
  5. What is Transdermal buprenorphine (Butrans) indicated for?
    Moderate to Severe chronic pain who will be on an opioid long term
  6. How is Transdermal buprenorphine (Butrans) metabolized?
    • CYP3A4
    • No renal reduction needed
  7. Do you need to reduce the dosese of Transdermal buprenorphine (Butrans) for renal insufficiency?
    No
  8. What are the benefits of Transdermal buprenorphine (Butrans)?
    • No peak
    • No trough
    • Slower increase
    • Lower SEs
  9. What are the risk of Transdermal buprenorphine (Butrans) at > 20 mcg/hour?
    QT prologation
  10. What are the doses of Transdermal buprenorphine (Butrans)?/
    5, 10 and 20 mcg/hour
  11. How often is Transdermal buprenorphine (Butrans) dosed?
    Weekly
  12. What is Opana?
    Oxymorphone
  13. What is the suggested elderly dose for Opanan IR (Oxymorphone)?
    5 mg Q6 hours
  14. What isteh suggested elederly dose for Opana ER?
    5 mg Q12 hours
  15. Describe the Metabolism/excretion of Opana (Oxymorphone):
    • No significant CYP450 metabolism
    • Renal excretion
    • Food with administration leads to high peak levels
    • Dose dumping with alcohol
  16. What is the dose ration fo Oxymorphone:Oxycodone?
    • 1:2
    • Oxymorphone:Oxycodone
  17. Oxymorphone has a 40% higher plasma concentration in what patient population?
    > 65 years
  18. What is Ultram?
    Tramadol
  19. What class of drug is tramadol (ultram)?
    SNRI and Opioid agonist
  20. What is the max daily dose of Tramadol (Ultram)?
    400 mg
  21. What is Ryzolt?
    Tramadol
  22. What us the max daily dose of Tramadol (Ryzolt)?
    300 mg
  23. What are the SE for Tramadol (Ultram)?
    • Seizures
    • Suicide risk
    • GI
  24. What group of patients should you adjust the dose of Tramadol (Ultram) in?
    • Elderly
    • Hepatic
  25. What types of pain is Tramadol (Ultram) particularly useful in treating?
    Chronic or Neuropathic pain
  26. What is Nucynta?
    Tapentadol
  27. What is the MOA of Tapentadol (Nucynta)?
    SNRI and Opioid agonist
  28. What are the indications of Tapentadol (Nucynta)?
    Moderate to severe pain
  29. What schedule is Tapentadol (Nucynta)?
    II
  30. What is the dose of Tapentadol (Nucynta)?
    • 50-100 mg Q4-6 hours
    • Max 700 mg/day
  31. What are the indications for Methadone?
    • Morphine allergy
    • Renal impairment
    • Neuropathic pain
    • Cancer pain
    • Pain refractory to other agents
  32. What are the precautions of Methadone pain?
    • Respiratory depression
    • QT-interval prolongation
  33. What is the Morphine: Methadone ratio, when morphine is <100 mg/day?
    • 3:1
    • What is the Morphine: Methadone ratio, when morphine is between101-300 mg/day?
    • 5:1
  34. What is the Morphine: Methadone ratio, when morphine is between 301-600 mg/day?
    10:1
  35. What is the Morphine: Methadone ratio, when morphine is between 601-800 mg/day?
    12:1
  36. What is the Morphine: Methadone ratio, when morphine is between 801-1000 mg/day?
    15:1
  37. What is the Morphine: Methadone ratio, when morphine is between >1001 mg/day?
    20:1
  38. Which Opiods are metabolized by the liver to active metabolites?
    Codeine and Meperidine
  39. What are the CYP2D6 metabolized opioids?
    • Codeine
    • Oxycodone
    • Hydrocodone
  40. Whata rethe general Opioid SEs?
    • CNS (sedation, clouding, confusion)
    • GI (constipation, N/V)
    • Repiratory depression
    • Pruritis

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