2023-11-26T02:13:43+03:00[Europe/Moscow] en true <p>false; have to assess short-acting usage before XR regimen </p>, <p>immediate release (IR) for breakthrough pain; 10-15% of TDD</p>, <p>nonpharmacological; nonopioid </p>, <p>start with IR formulations; prescribe lowest effective dose</p>, <p>stimulants/amphetamines; caffeine, modafinil, methylphenidate</p>, <p>chronic; breakthrough pain</p>, <p>combination of: long-acting/short-acting opioids, NSAIDs, acetaminophen</p>, <p>neuropathic</p>, <p>increases over time; more likely to have hyperalgesia/allodynia </p>, <p>TCAs, SNRIs, gabapentinoids, topicals </p>, <p>tramadol, combination of 1st line therapies </p>, <p>SSRIs, anticonvulsants, NMDA antagonists</p>, <p>opioids</p>, <p>neuromodulation </p>, <p>topicals </p>, <p>Gabapentinoid + TCA or + SNRI</p>, <p>elderly </p>, <p>middle-aged women </p>, <p>Fibromyalgia </p>, <p>pure mu-opioid receptor agonists, acetaminophen, NSAIDs</p>, <p>codeine, fentanyl, oxycodone </p>, <p>milnacipran, gabapentin, pregabalin, tramadol </p>, <p>Senna +/- docusate</p>, <p>inappropriate </p>, <p>add one or 2 additional agents; lactulose, MOM</p>, <p>impaction </p>, <p>mineral oil, magnesium citrate, enema </p>, <p>glycerin suppository, oil retention enema </p>, <p>normal BM</p>, <p>1 spray into 1 nostril; if desired response not achieved after 2-3 min; give second dose (new device) into alternate nostril; additional doses every 2-3 min until ER arrives</p>, <p>if desired response not achieved, dose should be repeated every 2-3 min; may need continuous infusion</p>, <p>after 10mg</p>, <p>Auto-Injector (Evzio)</p>, <p>decrease dose by 30%</p>, <p>5-10 MME; 20-30 MME</p>, <p>&gt; 50 MME/day </p> flashcards
Chronic Pain, Cancer Pain, Fibromyalgia (Therapeutics)

Chronic Pain, Cancer Pain, Fibromyalgia (Therapeutics)

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  • false; have to assess short-acting usage before XR regimen

    It is permissible to start a patient on a long-acting opioid. T/F?

  • immediate release (IR) for breakthrough pain; 10-15% of TDD

    What must be prescribed alongside a Long-acting Opioid?

    What is the dose?

  • nonpharmacological; nonopioid

    _________ and _______ therapies are preferred over opioids.

  • start with IR formulations; prescribe lowest effective dose

    What should we do when starting a patient on Opioids? (2)

  • stimulants/amphetamines; caffeine, modafinil, methylphenidate

    Which drugs are used for augmenting the action of opioids? (3)

  • chronic; breakthrough pain

    When treating cancer pain, the treatment must address ______ & _______.

  • combination of: long-acting/short-acting opioids, NSAIDs, acetaminophen

    What pain medications do we use for Cancer pain? (3)

  • neuropathic

    Which type of pain has a poor response to analgesics?

  • increases over time; more likely to have hyperalgesia/allodynia

    What are the characteristics of neuropathic pain? (2)

  • TCAs, SNRIs, gabapentinoids, topicals

    What are the 1st line treatment options for Neuropathic pain? (4)

  • tramadol, combination of 1st line therapies

    What are the 2nd line treatment options for Neuropathic pain? (2)

  • SSRIs, anticonvulsants, NMDA antagonists

    What are the 3rd line treatment options for Neuropathic pain? (3)

  • opioids

    What is the 5th line option for Neuropathic pain?

  • neuromodulation

    What is the 4th line option for Neuropathic pain?

  • topicals

    Which medication should we AVOID in diabetic neuropathy?

  • Gabapentinoid + TCA or + SNRI

    What is the combination therapy for Neuropathic pain? (2)

  • elderly

    Which patients with neuropathic pain should we AVOID using combination therapy?

  • middle-aged women

    Fibromyalgia is most common in _________.

  • Fibromyalgia

    -widespread somatic pain and deep tissue tenderness caused by

    sensitization of neural pain pathways; "pain all over"

  • pure mu-opioid receptor agonists, acetaminophen, NSAIDs

    Which medications do we NOT use in Fibromyalgia? (3)

  • codeine, fentanyl, oxycodone

    Which medications are Pure Mu-Opioid receptor agonists? (3)

  • milnacipran, gabapentin, pregabalin, tramadol

    Which medications do we use for Fibromyalgia? (4)

  • Senna +/- docusate

    What is the first option when treating Opioid-Induced Constipation?

  • inappropriate

    Docusate is _________ as a monotherapy for constipation.

  • add one or 2 additional agents; lactulose, MOM

    If the patient hasn't had a BM for 48 hours, what do we do/ what can we add?

  • impaction

    No bowel movements for 72 hours may indicate the patient has _______.

  • mineral oil, magnesium citrate, enema

    What are the treatment options for a patient with constipation >=72 hours with no impaction? (3)

  • glycerin suppository, oil retention enema

    What are the treatment options for a patient with constipation >=72 hours WITH impaction? (2)

  • normal BM

    Bulk-forming laxatives should be avoided until the patient has _________.

  • 1 spray into 1 nostril; if desired response not achieved after 2-3 min; give second dose (new device) into alternate nostril; additional doses every 2-3 min until ER arrives

    Opioid Reversal for Intranasal administration?

  • if desired response not achieved, dose should be repeated every 2-3 min; may need continuous infusion

    Opioid Reversal for IV/IM/SQ administration?

  • after 10mg

    Which IV/IM/SQ dose may indicate that the patient is NOT suffering from an

    opioid overdose?

  • Auto-Injector (Evzio)

    Which Naloxone device is no longer available?

  • decrease dose by 30%

    How do we switch from one opioid to another?

  • 5-10 MME; 20-30 MME

    What is the lowest, starting single dose?

    What is the maximum daily dosage?

  • > 50 MME/day

    At what dose do patients begin increasing the risk of AE's in Opioids?