Therapeutics - Pain 6

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Author:
kyleannkelsey
ID:
282534
Filename:
Therapeutics - Pain 6
Updated:
2014-09-13 12:09:02
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Therapeutics Pain
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Therapeutics - Pain 6
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  1. Local anesthetics come in what routes?
    • Regional: Lidocaine, Bupivicaine, Ropivacaine
    • Topical: Lidocaine and Prilocaine
  2. What is a major use of a 5% lidocaine patch?
    Neuropathic pain
  3. What is a major use of an EMLA lidocaine or prilocaine?
    Kids
  4. What pain drugs are usually given with epidurals?
    Bupivacaine or fentanyl
  5. Scheduled dosing requires need for instructions for ___________ pain
    Breakthrough
  6. What dosage form is most desired for pain medication?
    Oral
  7. Are IV pain meds more effective than oral?
    No, just faster
  8. What opioids should be dosed every 4 hours?
    • Morphine
    • Oxycodone
    • Hydromorphone
  9. What opioids should be dosed every 6-8 hours?
    Methadone
  10. What opioids should be dosed every 1-2 hours?
    TransMUCOSAL Fentanyl
  11. What opioids should be dosed every 8-12 hours?
    MS Contin
  12. What opioids can be dosed daily?
    Avinza or Kadian
  13. What opioids can be dosed every 12 hours?
    • MS COntin
    • Kadian
    • Oxycontin
  14. What opioid can be dosed every 72 hours?
    TransDERMAL Fentanyl
  15. How much should you reduce the equianalgesic dose if a patient is switching from one opioid to another?
    25-33%
  16. 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
  17. That is the Equianalgesic dose of oral Hydromorphone to 30 mgs of Morphine?
    7.5 mg
  18. That is the Equianalgesic dose of oral Oxycodone to 30 mgs of Morphine?
    20 mg
  19. That is the Equianalgesic dose of oral Methadone to 30 mgs of Morphine?
    10 mg
  20. That is the Equianalgesic dose of oral Meperidine to 30 mgs of Morphine?
    300 mg
  21. That is the Equianalgesic dose of oral Codeine to 30 mgs of Morphine?
    200 mg
  22. That is the Equianalgesic dose of IV Hydromorphone to 10 mgs of Morphine?
    1.5 mg
  23. That is the Equianalgesic dose of IV Methadone to 10 mgs of Morphine?
    5 mg
  24. That is the Equianalgesic dose of IV Meperidine to 10 mgs of Morphine?
    75 mg
  25. That is the Equianalgesic dose of IV Codeine to 10 mgs of Morphine?
    120 mg
  26. A rectal suppository dose of an opioid is approximately equal to what?
    The oral dose
  27. How do you calculate the breakthrough pain dose?
    10-15% of total daily pain regimen
  28. What is the concentration of Roxanol?
    20 mg/mL morphine
  29. What is the concentration of Morphine Sulfate?
    20 mg/5 mL morphine
  30. What is the concentration of Paregoric?
    0.4 mg/mL morphine
  31. What is the concentration of tincture of opium?
    10 mg/mL morphine
  32. 200 mg oral morphine = _______ Fentanyl patch
    100mcg
  33. 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
  34. When should you not use Fentanyl transdermal?
    As first narcotic tried for pain
  35. Severe pain rated 7-10 requires what dose adjustment?
    50-100% increase
  36. Moderate pain rated 4-6 requires what dose adjustment?
    25-50% increase
  37. When you dose adjust baseline pain meds, should you also dose adjust breakthrough pain medications?
    Yes
  38. Pain above what level interferes with QOL?
    >4
  39. You should reassess moderate pain control in what time frame?
    24-48 hours
  40. You should reassess severe pain control in what time frame?
    • Oral: 1-24 hours
    • IV: 15 minutes
  41. When should you switch a patient with severe chronic pain from IR to SR with breakthrough IR?
    When pain falls below 4
  42. What is the standard for treating neuropathic pain?
    • None
    • Though TCAs have been most studied
  43. Are opioids useful in treating neuropathic pain?
    Often unresponsive
  44. What is the OOA for TCAs in the treatment of neuropathic pain?
    4-12 weeks
  45. You may not become addicted to an opioid pain medication, but you will become __________ and ___________ with chronic use.
    Tolerant and Dependant
  46. What is tolerance?
    Physiological adaptation to the continuous presence of a drug in the body
  47. What is Dependence?
    Physiological state that precipitates withdrawal when drug is removed
  48. What is Addiction?
    • Chronic PSYCHOLOGICAL (BEHAVIORAL) disorder that requires use of a drug despite harm
    • Includes: compulsive use
    • Impaired control
    • Cravings
  49. (True/False) Opioid addiction is common in cancer patients.
    False
  50. How do COX-2 inhibitors compare to other NSAIDs in terms of Cardio toxicity?
    Same, except for naproxen, which is a better choice

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