Term
| dull, aching, throbbing, localized, worse with movement |
|
Definition
|
|
Term
| irritable bowel pain, gas pain |
|
Definition
|
|
Term
| lightening, streaking, radiating, pins and needles, electrical |
|
Definition
|
|
Term
| Charlie horse, gripping, spasms |
|
Definition
|
|
Term
|
Definition
| opioids, NSAIDs, Calcitonin, bisphosphonates, Steroids, Radiation |
|
|
Term
|
Definition
| difficult to treat; may use nerve blocks, itnrathecal w/ opioid and/or local anesthetic; epidural; octreotide; antispasmodics |
|
|
Term
| neuropathic pain treatment |
|
Definition
| TCAs, SNRIs, anticonvulsants, topiramate, capsaicin, Lidoderm patches, steroids, opioids |
|
|
Term
| drug of choice for pregnancy and patients on warfarin |
|
Definition
|
|
Term
| synergistic with acetaminophen and/or opioids; ceiling effect (increased dose gives no added analgesia); not recommended to be used in heart failure ; use caution in patients on warfarin |
|
Definition
|
|
Term
| Advantages include no ceiling effect; Disadvantages include GI effects and physical dependency |
|
Definition
|
|
Term
|
Definition
| decreased peristalsis and intestinal secretions due to interaction with the mu-2 receptors in the GI tract |
|
|
Term
|
Definition
| interaction with the MOR-1D receptor which subsequently connect to GRPR to relay itch signals |
|
|
Term
| Nausea and vomiting in opioids |
|
Definition
| activation of opioid receptors in the chemotherapy trigger zone |
|
|
Term
| Respiratory depression in opioids |
|
Definition
| interaction with the mu-2 (and possibly delta) opioid receptors in the brain |
|
|
Term
|
Definition
| interaction with kappa opioid receptors in the brain |
|
|
Term
| can be opened and sprinkled into food |
|
Definition
| Kadian (long acting morphine) |
|
|
Term
|
Definition
| used in dyspnea management and myocardial infarctions |
|
|
Term
| morphine 6-glucuronide (metabolite) |
|
Definition
|
|
Term
| morphine 3-glucuronide (metabolite) |
|
Definition
| toxic, can accumulate in patients with renal failure and may lead to seizures |
|
|
Term
| Advantages include more potent and faster onset; lower SEs and once daily ER formulation, no major metabolites; Disadvantages include more expensive, less formulations, higher risk |
|
Definition
|
|
Term
| Not used orally due to erratic absorption |
|
Definition
|
|
Term
| Meperidine (Demerol) cautions |
|
Definition
| do not use for more than 48 hours; do not give more than 600 mg/day; never use for chronic pain |
|
|
Term
| because of fast onset of action there is an increased risk of respiratory depression and death with transmucosal forms |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| prodrug whose active metabolite is morphine |
|
|
Term
| Codeine + APAP (Tylenol #3) |
|
Definition
| 10-30% of dose is metabolized into morphine by CYP2D6 |
|
|
Term
|
Definition
| Phenothiazine, haloperidol, fluoxetine, paroxetine |
|
|
Term
| several reports of death in patients who are ultra-rapid metabolizers (CYP2D6) |
|
Definition
|
|
Term
| schedule III drug; more pain relief and longer duration than codeine, better tolerated than codeine |
|
Definition
| Hydrocodone + APAP (Norco, Vicodin, Lortab) |
|
|
Term
| better tolerated than morphine, more potent analgesic than codeine or hydrocodone |
|
Definition
| Oxycodone (Roxycodone, Oxyccontin, Percocet) |
|
|
Term
|
Definition
| contains an active metabolite with a 7-9 hour half life; risk of respiratory depression when used with CYP3A4 |
|
|
Term
|
Definition
| macrolides, azoles, protease inhibitors |
|
|
Term
| long duration of action; inexpensive, may be more effective for neuropathic pain, less euphoria, less constipation; difficult to dose-- QT prolongation at high doses |
|
Definition
|
|
Term
| gives methadone its opioid activity |
|
Definition
|
|
Term
| NMDA receptor antagonist and an NE and serotonin reuptake inhibitor |
|
Definition
|
|
Term
| Food increases Cmax by 50%-- administer on an empty stomach; twice a potent as oxycodone; |
|
Definition
| Oxymorphone (Opana, Opana ER, Numorphan) |
|
|
Term
| Mixed Agonist-Antagonists |
|
Definition
| Pentazocine, Butorphanol, Nalbuphine |
|
|
Term
| less respiratory depression, less physical dependency, schedule IV; Ceiling effect, CNS effects |
|
Definition
| Mixed agonist-antagonists |
|
|
Term
|
Definition
| Buprenorphine (Buprenex, Subutex, Butrans) |
|
|
Term
| High doses = Addiction; Low Doses = Pain |
|
Definition
|
|
Term
|
Definition
| opioid detox w/ suboxone; decreases or prevents craving; treats pain; transdermal patch 1 every 7 days |
|
|
Term
| Buprenorphine disadvantages |
|
Definition
| ceiling effect, high receptor affinity, can be difficult to reverse respiratory depression, can bind to opioid receptors for up to 48 hours; transdermal patch is not for acute pain |
|
|
Term
|
Definition
| Naloxone, Naltrexone, methylnaltrexone, Alvimopan |
|
|
Term
| used for opioid overdose, respiratory depression reverse constipation or ileus without reversing analgesia |
|
Definition
|
|
Term
| used for opioid dependency, ethanol dependency |
|
Definition
| Naltrexone (Revia, Vivitrol) |
|
|
Term
| SC injection used for treatment of opioid-induced constipation when response to laxative therapy has been insufficient |
|
Definition
| Methylnaltrexone (relistor) |
|
|
Term
| NTE 2 grams/day if history of liver disease or alcoholism |
|
Definition
|
|
Term
| weak mu-receptor binding; inhibition of norepinephrine serotonin reuptake (SNRI) |
|
Definition
| Tramadol (ultram, ultram ER, ryzolt, ultracet) |
|
|
Term
|
Definition
| non-controlled, less respiratory depression, good for neuropathic pain, minimum physical dependency |
|
|
Term
| disadvantages of tramadol |
|
Definition
| risk of serotonin syndrome, lowers seizure threshold, may be less effective |
|
|
Term
| inhibits spinal reflexes, structural analog of gamma-aminobutryric acid (GABA) |
|
Definition
|
|
Term
| use caution in renal or liver impairment, prodrug of meprobamate, low doses may be just as effective as high doses, potential for abuse |
|
Definition
|
|
Term
| structurally related to amitriptyline, greatest evidence for efficacy, low dose maybe just as effective, potential for abuse |
|
Definition
| Cyclobenzaprine (Flexeril) |
|
|
Term
| neuronal inhibition via GABA receptors; available IV/IM |
|
Definition
|
|
Term
| Significant effects include urine discoloration (brown, green) |
|
Definition
|
|
Term
| Significant Effects: paradoxical muscle cramps, mild withdrawal symptoms |
|
Definition
|
|
Term
| dizziness, somnolence, blurred vision, edema, weight-gain; decrease dose in renal impairment |
|
Definition
|
|
Term
| same effects as Lyrica.....not indicated for neuropathic pain, less effective |
|
Definition
|
|
Term
| increase BP, HR, sexual side effects, restless leg syndrome |
|
Definition
|
|
Term
| can be used for suicide. doses fro pain are lower than doses for depression |
|
Definition
|
|
