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OTC Pain Management

OTC Pain Management lecture for PCI

QuestionAnswer
Name 5 neurotransmitters involved in the transmission of pain impulses 1. Prostaglandins, 2. Bradykinin, 3. Serotonin, 4. Substance P, and 5. Histamine
Max daily dose of acetaminophen for adults 4000mg/day
Adult dosage of acetaminophen. 325-1000 mg q4-6hr PRN pain or fever
Children dosage of acetaminophen 10-15 mg/kg/dose q4-6hr PRN pain or fever
Strength of Infant Drops Tylenol 80mg/0.8mL
Strength of Children's Liquid Tylenol 160mg/5mL
Strength of Adult Liquid Tylenol 500mg/15mL
DI for acetaminophen Chronic alcohol use, liver disease, hepatotoxic meds, pts w/ G6PD deficiency, large doses for pts receiving warfarin
Acute overdose of acetaminophen leads to what? Hepatic necrosis and renal tubular necrosis
MOA of NSAIDs Inhibits prostaglandin synthesis peripherally by inhibiting COX-1 and COX-2
Uses for NSAIDs. Analgesic, antipyretic, and anti-inflammatory
Uses for acetaminophen. Analgesic and antipyretic. NOT anti-inflammatory
DI for NSAIDs Alcohol use, liver disease, anticoagulants, sulfonylureas, lithium, corticosteroids, valproic acid, phenytoin, methotrexate, digoxin, gout/hyperuricemia, hypertension, peptic ulcer disease, and cardiovascular disease
AE of NSAIDs GI upset and ulceration, inhibit platelet aggregation, high doses are potentially additive to anticoagulant effects, hypoglycemia
What triad should you beware of for toxicity in NSAIDs? Asthma, nasal polyps, and aspirin allergy
Adult dosage of ibuprofen 200-400mg q4-6hr
Max daily dose of ibuprofen for adults 1200mg/day
Adult dosage of naproxen sodium 220mg q6-8-12hr
Adult dosage of ketoprofen 12.5-25mg q6-8hr
Child dosage of ketoprofen N/A for under age 16. For > 16, use adult dosage
Child dosage of naproxen N/A for under age 12. For >12, use adult dosage
Child dosage of ibuprofen 7.5mg/kg q4-6hr
Max daily dose of ibuprofen for children 30mg/kg/day
Max daily dose of naproxen sodium for adults 660mg/day
Max daily dose of ketoprofen for adults 75mg/day
Max daily dose of aspirin for adults 4000mg/day
Adult dosage of aspirin 650-1000mg q4-6hr
Adult dosage of magnesium salicylate 650mg q4hr or 1090 q8hr
Max daily dose of magnesium salicylate for adults 4800mg/day
Max daily dose of sodium salicylate for adults 3900mg/day
Adult dosage of sodium salicylate 650mg q4hr
What kind of salicylate causes irreversible inhibition of platelet aggregation? Acetylated salicylate
Avoid use of salicylates w/ GI bleeding; Renal/hepatic disease; children <15 yo; Chronic alcohol use; Asthma, nasal polyps triad; Concomitant drug therapy; Surgery; Gout; Pregnant/breast-feeding; Diabetes; Hypertension; Drug interactions severe or unmanageable; Aspirin allergy
MOA of methyl salicylate Unknown
MOA of camphor Low concentrations - depression of cutaneous receptor response; High concentrations - stimulation of cutaneous receptors
MOA of Menthol Low concentrations - depression of cutaneous receptor response; High concentrations - stimulation of cutaneous receptors
MOA of Capsaicin Depletion of Substance P
MOA is Low concentrations - depression of cutaneous receptor response; High concentrations - stimulation of cutaneous receptors Camphor and Menthol
MOA is depletion of Substance P Capsaicin
Name four counterirritants Methyl salicylate, camphor, menthol, capsaicin
Severe pain - refer or treat? Refer
Undiagnosed headache pain > 10 days - refer or treat? Refer
Diagnosed headache pain - refer or treat? Treat
Severe diagnosed headache pain - refer or treat? Refer
Headache and last trimester of pregnancy - refer or treat? Refer
Headache and first trimester of pregnancy - refer or treat? Treat
Headache and breast-feeding - refer or treat? Refer
Headache and 8 yo or older - refer or treat? Treat
Headache and 7 yo or younger - refer or treat? Refer
Headache and hx of liver disease - refer or treat? Refer
Headache and consumption of 3 or more alcoholic drinks per day - refer or treat? Refer
Headache and consumption of 2 alcoholic drinks per day - refer or treat? Treat
Secondary headache - refer or treat? Refer
Migraine-like symptoms w/o formal diagnosis of migraine headaches - refer or treat? Refer
Migraine-like symptoms w/ formal diagnosis of migraine headaches - refer or treat? Treat
High fever or sign of serious infection - refer or treat? Refer
Muscle pain for greater than 2 weeks - refer or treat? Refer
Muscle pain for 8 days - refer or treat? Treat
Muscle pain or joint pain that persists after 10 days of treatment - refer or treat? Refer
Joint pain more severe than diagnosed arthritis pain - refer or treat? Refer
Pain distribution along a nerve - refer or treat? Refer
Rheumatoid arthritis - refer or treat? Refer
Nonpharmacologic treatment for pain. Rest; Ice; Compression; Elevation; Heat (joint/muscle injuries); Relaxation and stretching (tension headaches)
Complementary, nonpharmacological pain treatments. Herbals, acupuncture, jagnesium (headache prophylaxis)
What type of headache has no underlying disease and may be responsive to OTCs? Primary
What type of headache has symptoms of other disease and is seldom/rarely self-treatable and should be referred. Secondary
Tension headache - refer or treat? Treat
Previously diagnosed migraine headache - refer or treat? Treat
Undiagnosed migraine headache - refer or treat? Refer
Sinus headache - refer or treat? Treat
Mixed-type headache - refer or treat? Treat
Fatigue headache - refer or treat? Treat
Eye-strain headache - refer or treat? Treat
Hangover headache - refer or treat? Treat
Rebound headache- refer or treat? Treat
Infection headache - refer or treat? Refer
Ice for the first ________ hours followed by hear after ___________ hours. 48-72 hours; 48-72 hours
Treat joint pain NMT ______ days before referral. 10 days
Number one treatment for osteoarthritis Acetaminophen
Created by: P1StudyStack
 

 



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