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Duke PA ortho pharm
Duke PA ortho pharm general info
| Question | Answer |
|---|---|
| Acetaminophen (tylenol) | Efficacy comparable to aspirin, first line therapy for osteoarthritis. No good antiinflammatory action |
| Aspirin | First NSAID, Irreversible platelet effects |
| Ibuprofen (motrin, rufen, nuprin, advil) | NSAID-200 mg superior to 650 mg aspirin. Better antiinflammatory than acetaminophen. |
| Naproxen(naprosyn)naproxen Na (anaprox,aleve) | NSAID-275 mg Na salt comparable to 650 mg aspirin with slower onset and longer duration |
| Ketorolac (toradol) | NSAID 30-60 mg is comparable to 6-12 mg morphine |
| Celecoxib (celebrex) | Selective COX-2 inhibitor-use sparingly if at all, short term reduction of GI toxicity |
| diclofenac patch (Flector) | Topical NSAID strains, sprains, contusions |
| diclofenac gel (Voltaren) | Topical NSAID approved for osteoarthritis |
| Tramadol | Opioid-adjust for renal function, not a controlled substance |
| Meperidine (demerol/demonal) | Opioid-not recommended. Metabolite causes CNS toxicity, accumulates due to long half-life. |
| Nalbuphine | Kappa-opioid not recommended |
| Butorphanol | Kappa-opioid not recommended |
| Dexocine | Kappa-opioid not recommended |
| Buprenorphine | Kappa-opioid not recommended |
| Pentazocine | Kappa-opioid not recommended |
| Propoxyphene (darvocet/darvocrap) | Opioid-not recommended, efficacy in trials no more than that of 650 mg ASA or APAP. Metabolite accumulation may cause seizures. |
| Used for neuromuscular conditions. Little evidence for use in musculoskeletal conditions | Antispastic |
| Used for musculoskeletal spasms related to injury. Evidence supports SHORT TERM use | Antispasmodic |
| Cyclobenzaprine (Flexeril) | tricylclic antidepressant used clinically as a muscle relaxant/antispasmodic |
| Methocarbamol (Robaxin) | muscle relaxant/antispasmodic |
| Tizanidine (Zanaflex) | muscle relaxant/antispasmodic |
| Carisoprodol (soma) | Muscle relaxant |
| Chlorzoxazone (parafon forte) | muscle relaxant/antispasmodic |
| Tizanidine (zanaflex) | muscle relaxant/antispasmodic |
| Pregabalin (lyrica) | indicated for fibromyalgia |
| Gabapentin (Neurontin) | indicated for fibromyalgia |
| Seldom warranted for back pain | Opioids in general |
| Amitriptyline | Tricyclic antidepressant-low doses indicated for treatment of back pain. |
| duloxetine (Cymbalta) | SNRI-Used for treatment of subacute and chronic musculoskeletal pain |
| venlafaxine (Effexor) | SNRI-Used for treatment of subacute and chronic musculoskeletal pain |
Created by:
bwyche
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