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Analgesics

Musculoskeletal disorders, Headaches & Fever

QuestionAnswer
What are all the different kinds of musculoskeletal disorders? Myalgia, tendonitis, Bursitis, Sprains, Lower back pain & Osteoarthritis
What are the symptoms of these musculoskeletal disorders? Pain, swelling, warmth, bruising, erythema
Musculoskeletal disorders: Exclusions for self treatment (Card#1) Moderate to severe pain (pain score over 6), Pain that lasts for over 2 weeks, Pain that continues 7 days after treatment, increased intensity of change in character of pain, pelvic or abdominal pain, N/V, fever, systemic infection
Musculoskeletal disorders: Exclusions for self treatment (Card#2) Visually deformed joint or abdominal movement, weakness in limb, suspected fracture, 3rd trimester of pregnancy, under 2yo
Musculoskeletal disorders: Non-Pharm therapy Lifestyle changes like physical therapy and weight loss, stretching muscles, proper hydration, not pushing until the point of exhaustion, RICE therapy
Musculoskeletal disorders: Pharmacologic therapy: What are all the different kinds of pharm therapy? Systemic analgesics (APAP and NSAIDS), Topical products (local analgesic, anesthetic, antipruretic, counterirritant)
Musculoskeletal disorders - Pharmacologic therapy: Methyl Salicylate - MOA Vasodilation of vasculature, responsible for hot action
Musculoskeletal disorders - Pharmacologic therapy: Methyl Salicylate - Dosing Apply no more than 3-4 times a day for up to 7 days
Musculoskeletal disorders - Pharmacologic therapy: Methyl Salicylate - Adverse effects Localized rash, systemic toxicity AVOID IN CHILDREN, can effect warfarin levels
Musculoskeletal disorders - Pharmacologic therapy: Camphor - MOA Produces a cooling sensation
Musculoskeletal disorders - Pharmacologic therapy: Camphor - Dosing and precautions Apply no more than 3-4 times a day for up to 7 days, must be in concentrations less than 11% to be safe for self care, very toxic if consumed
Musculoskeletal disorders - Pharmacologic therapy: Camphor - Adverse effects Dont use in pediatrics
Musculoskeletal disorders - Pharmacologic therapy: Menthol - MOA Initial feeling of coolness followed by a warming sensation (used in less concentrated amounts for cough releif - vaporub)
Musculoskeletal disorders - Pharmacologic therapy: Menthol - Dosing Apply no more than 3-4 times a day for up to 7 days
Musculoskeletal disorders - Pharmacologic therapy: Capsicum - MOA lasts for 4-6 hours and relief occurs after 14 days
Musculoskeletal disorders - Pharmacologic therapy: Capsicum - Adverse effects Use gloves, burning/ itching in 40-70% of people
Headaches: What are the types of primary headaches? Tension-type, migraine, cluster, med-induced and sinus
Headaches: What is there to know about secondary headaches? They're due to infarction, hemorrhage etc SHOULD ALWAYS REFER
Headaches - Primary: what are the different types of tension-type? Episodic (with or without aura) and chronic (if occurs more than 15x/month - refer!)
Headaches - Primary: what are the different types of migraines? Episodic (with or wihout aura) and Chronic (if its over 15x/month refer!)
Headaches: Nonpharm therapy for tension-type relaxation and trigger avoidance
Headaches: Nonpharm therapy for migraines trigger avoidance, regular schedule for eating/sleeping, stress management, ice, applied pressure over temples
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - MOA Inhibits COX1&2 prosteglandin synthesis
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - When to recommend Mild to moderate pain, mild to moderate fever (antipyretic), for heart protection to prevent MI and stroke
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Dosing 650-1000mg q 4-6h MAX 4000mg
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Councelling Full glass of water!
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Safety considerations GI irritation, potentiation of bleeding, ASA intolerance, Uric acid elimination, avoid in patients with gout or hyperuricemia
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Considerations Renal or hepatic dysfunctions-CAUTION. Bleeding disorder-peptic ulcer disease. Hypoprothrombinemia, vitamin K deficiency, hemophelia
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Drug interactions Warfarin and alcohol
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Pregnancy Maternal and fetal adverse effects, avoid in pregnancy, particularly in last trimester
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Breast feeding its excreted in breast milk in low concentrations, avoid while breastfeeding
Headaches: Pharm therapy - Acetylated Salycilates (aspirin) - Pediatrics/teenagers avoid all salicylates during viral illness due to reyes syndrome
Headaches: NSAIDS (ibuprofen) - MOA inhibits COX and prosteglandin synthesis, peripheral inhibition of COX 1&2
Headaches: NSAIDS (ibuprofen) - when not to take it Pregnant, liver failure/alcoholic, 60yo, HF, nasal polypse and asthma, OA, hypertension
Headaches: NSAIDS (ibuprofen) - drug interactions warfarin, Aspirin(separate doses by 8 hours)
Headaches: NSAIDS (ibuprofen) - Considerations may cause dyspepsia, HB, N, anorexia and epigastric pain. Increased risk for bleeding, kidney dysfunction,
Headaches: NSAIDS (ibuprofen) - pregnancy avoid in 3rd trimester
Headaches: NSAIDS (ibuprofen) - breast feeding ok (2.4g/day)
Headaches: NSAIDS (ibuprofen) - pediatrics ok (5-10mg/kg)
Headaches: NSAIDS (ibuprofen) - geriatrics Dont use it, use acetaminophen
Headaches: NSAIDS (Naproxen) - MOA inhibits COX and prosteglandin synthesis, peripheral inhibition of COX 1&2
Headaches: NSAIDS (Naproxen) - When not to take it pregnant, 60+yo, alcoholic/liver failure, if you have aspirin intolerance, HF, nasal polypse or asthma, OA, premenstrual cramps, hypertension
Headaches: NSAIDS (Naproxen) - Drug interactions Warfarin
Headaches: NSAIDS (Naproxen) - Considerations may cause dyspepsia, HB, N, anorexia and epigastric pain. Increased risk for bleeding, kidney dysfunction
Headaches: NSAIDS (Naproxen) - pregnancy ok
Headaches: NSAIDS (Naproxen) - pediatrics only over 12 yo
Headaches: NSAIDS (Naproxen) - geriatrics dont use naproxen, use acetaminophen
Headaches: NSAIDS (Naproxen) - Dosing 220-440mg q 8-12h MAX 660mg/day
Headaches: NSAIDS (Ibuprofen) - Dosing 200-400mg q 4-6h MAX 1200mg/day
Headaches: Acetaminophen - MOA inhibits COX 1&2 and PG synthesis in the CNS
Headaches: Acetaminophen - when not to take it liver failure, alcoholics, to decrease inflammation
Headaches: Acetaminophen - Drug interactions warfarin ok
Headaches: Acetaminophen - pregnancy and breastfeeding ok
Headaches: Acetaminophen - pediatrics ok
Headaches: Acetaminophen - Geriatrics ok
Headaches: Acetaminophen - Dosing 325-1000mg q 4-6h MAX 4000mg
Headaches: Acetaminophen - Exclusions for self treatment Severe head pain, headaches that last 10 days, 3rd trimester, under 8yo, high fever, secondary headaches, migraine symptoms
Headaches: Children's dosing (Acetaminophen) 10-15mg/kg q 4-6h no more than 5 doses /day
Headaches: Children's dosing (ibuprophen) 5-10mg/kg
Fever: how hot is a fever? 100 degrees F, hypothalamus acts as a thermostat
Fever: Signs and symptoms Headache, diaphoresis, chills, fatigue, disorientation, general malaise, tachycardia, arthralgia/myalgia, irritability (temp of 102 can cause these)
Fever: what are the different types of thermometers Electric, tympanic, skin, infrared
Fever: Nonpharm fluid intake, wear light clothing, removing blankets, room temp of 78 degrees
Fever: Pharm therapy - what to use if you have a fever NSAIDS, APAP, ASA
Fever: Cildrens dosing (ibuprofen) 5mg/kg if fever is under 102.5 / 10mg/kg if fever is above 102.5 q 6-8h MAX 40mg/kg/day
Fever: NSAIDS - when to discontinue if the fever doesnt get better in 3 days
Fever: exclusions for self treatment under 6mo with rectal temp of 104, over 6 mo with rectal temp = 101, symptoms of infection, risk for hyperthermia, COPD, HF, Cancer, HV, impaired CNS function, head trauma, stroke, history of febrile seizures, seizure disorder
Created by: carlypentland
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