Therapeutics - Pain 6
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. What would you like to do?
Local anesthetics come in what routes?
- Regional: Lidocaine, Bupivicaine, Ropivacaine
- Topical: Lidocaine and Prilocaine
What is a major use of a 5% lidocaine patch?
What is a major use of an EMLA lidocaine or prilocaine?
What pain drugs are usually given with epidurals?
Bupivacaine or fentanyl
Scheduled dosing requires need for instructions for ___________ pain
What dosage form is most desired for pain medication?
Are IV pain meds more effective than oral?
No, just faster
What opioids should be dosed every 4 hours?
What opioids should be dosed every 6-8 hours?
What opioids should be dosed every 1-2 hours?
What opioids should be dosed every 8-12 hours?
What opioids can be dosed daily?
Avinza or Kadian
What opioids can be dosed every 12 hours?
What opioid can be dosed every 72 hours?
How much should you reduce the equianalgesic dose if a patient is switching from one opioid to another?
Should you reduce eth equianalgesic dose if a patient is switching from one dosage form of and opioid to another?
No, only if changing opiods
That is the Equianalgesic dose of oral Hydromorphone to 30 mgs of Morphine?
That is the Equianalgesic dose of oral Oxycodone to 30 mgs of Morphine?
That is the Equianalgesic dose of oral Methadone to 30 mgs of Morphine?
That is the Equianalgesic dose of oral Meperidine to 30 mgs of Morphine?
That is the Equianalgesic dose of oral Codeine to 30 mgs of Morphine?
That is the Equianalgesic dose of IV Hydromorphone to 10 mgs of Morphine?
That is the Equianalgesic dose of IV Methadone to 10 mgs of Morphine?
That is the Equianalgesic dose of IV Meperidine to 10 mgs of Morphine?
That is the Equianalgesic dose of IV Codeine to 10 mgs of Morphine?
A rectal suppository dose of an opioid is approximately equal to what?
The oral dose
How do you calculate the breakthrough pain dose?
10-15% of total daily pain regimen
What is the concentration of Roxanol?
20 mg/mL morphine
What is the concentration of Morphine Sulfate?
20 mg/5 mL morphine
What is the concentration of Paregoric?
0.4 mg/mL morphine
What is the concentration of tincture of opium?
10 mg/mL morphine
200 mg oral morphine = _______ Fentanyl patch
What counseling tips should you give a patient starting on a Fentanyl patch?
- 12-18 hours before pain relief
- Remove when you apply a new one Q72 hours
- Fold in half and put in a sharps container after use
When should you not use Fentanyl transdermal?
As first narcotic tried for pain
Severe pain rated 7-10 requires what dose adjustment?
Moderate pain rated 4-6 requires what dose adjustment?
When you dose adjust baseline pain meds, should you also dose adjust breakthrough pain medications?
Pain above what level interferes with QOL?
You should reassess moderate pain control in what time frame?
You should reassess severe pain control in what time frame?
- Oral: 1-24 hours
- IV: 15 minutes
When should you switch a patient with severe chronic pain from IR to SR with breakthrough IR?
When pain falls below 4
What is the standard for treating neuropathic pain?
- Though TCAs have been most studied
Are opioids useful in treating neuropathic pain?
What is the OOA for TCAs in the treatment of neuropathic pain?
You may not become addicted to an opioid pain medication, but you will become __________ and ___________ with chronic use.
Tolerant and Dependant
What is tolerance?
Physiological adaptation to the continuous presence of a drug in the body
What is Dependence?
Physiological state that precipitates withdrawal when drug is removed
What is Addiction?
- Chronic PSYCHOLOGICAL (BEHAVIORAL) disorder that requires use of a drug despite harm
- Includes: compulsive use
- Impaired control
(True/False) Opioid addiction is common in cancer patients.
How do COX-2 inhibitors compare to other NSAIDs in terms of Cardio toxicity?
Same, except for naproxen, which is a better choice
What would you like to do?
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