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Pain Management
| Question | Answer |
|---|---|
| Mu receptors | produce analgesia, resp depression, sedation, euphoria, dependence, constipation |
| K receptors | analgesia, resp depression, anxiety, hallucinations |
| Delta receptors | analgesia without adverse events |
| pure opioid agonists (mu mostly, some kapp) examples | fentanyl, hydromorphone, levophanol, mepiridine, methadone, morphine, oxycodone, oxymorphone |
| moderate-mild opioids examples | codeine, hydrocodone, propoxyphene |
| mixed agonist-antagonist (Kappa, weak on mu) examples | pentazocine, butophanol, nalbuphine, buprenorphine, dezocine |
| Opioid antagonists that block but mu and kappa examples | Naloxone, Naltrexone, Nalmefene |
| mixed agonist-antagonist effects | more euphoria, psychomimetic effects, less resp depression |
| opioid antagonists effects | used to reverse resp depression and CNS depression |
| opioid ADRs | CNS effects, chronic sedation, muscle jerks, changes in hormone levels, high doses create convulsions, resp depression, orthostatic hypotension, N/V, constipation, bladder spasm and urgency, urinary retention, flushing of face, sweating, pruritis |
| opioids DDI | CNS depressants, anticholinergics, TCAs, atropine, antihypertensives, MAOI's |
| ASA + APAP + Caffeine | Excedrin |
| Abortive therapy for migraines | Ergotamine, Combinations with caffeine, Dihydroergotamine, triptans |
| Ergotamine ADR | N/V, weakness in legs, myalgia, numbness/tingling, angina-like, tachycardia, bradycardia; overdose can cause ergotism -- ischemia, myalgias, parethesias, gangrene |
| Ergotamine DDIs/Drug-dz interactions | SSRIs (separate by 24 hrs), Ci in renal or hepatic impairment, sepsis, CAD, PVD |
| Ergotamine | Ergomar, Ergostat, Wigrettes, Gynergen, Medihaler-Mergotamine |
| Ergotamine/Caffeine | Cafergot, Wigraine |
| Ergotamine/pentobarbital/bellafoline | bellergal |
| ergotamine/pentobarbital/belladona/caffeine | cafergot PB |
| Isometheptene/dichloralphenazone/APAP | midrin |
| Dihydroergotamine | little peripheral vasoconstriction, n/v or physical dependence but diarrhea predominant |
| DHE CI | CAD, PVD, pregnancy, sepsis, hepatic or renal impairment; dont give within 24 hrs of SSRI |
| Triptan ADR | tingling, parethesias, warmth of head, neck, chest, limbs, dizziness, flushing, back pain, stiffness, chest symptoms, heavy arms, agina (rarE), vertigo, malaise, fatigue |
| Triptan DDI/D-DzI | ergots, triptans, MAOI's; CI in IHD, MI, uncontrolled HTN |
| Almotriptan | Axert |
| Sumatriptan | Imitrex |
| Eletriptan | Relpax |
| Frovatriptan | Frova |
| Rizatriptan | Maxalt |
| Zolmitriptan | Zomig |
| Naratriptan | Amerg |
| migraine prophylaxis | beta blockers, anticonvulsants, antidepressants, CCBs, methysergide |
| Beta blockers in migraine prophylaxis | propranolol and timolol DOC |
| Antidepressants in migraine prophyalxis | amitriptyline, fluoxetine |
| Divalproex ADR | weight gain, hair loss, tremor, teratogenic |
| Topiramate ADR | parethesia, fatigue, nausea, dizziness, difficulty concentration, wieght loss, anorexia |
| Methysergide | ergot alkaloid |
| Methyseride ADR | retroperitoneal, pleuropulmonary, cardiac fibrosis, vascular insufficiency, insomina, altered mood, depersonalization, hallucinations, nightmares, GI disturbances, N/V, diarrhea |
Created by:
cytoskeletor
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