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53 Cards in this Set

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contraindicated if
sulfonamide allergy
Celebrex
Only 1 in 5 people who develop a serious upper
GI adverse event on NSAID therapy is
symptomatic
Risk of gi bleed with NSAIDS increases with concurrent oral
corticosteroids, anticoagulants
__ can cause fluid retention and peripheral
edema, particularly __
NSAIDS, indomethacin
Potentially fatal hypersensitivity syndrome
Clinoril
Anaphylactoid reactions
are typically in asthmatic patients and more common in patients that are
hypersensitive
to aspirin
Reduce dose of NSAIDS in patients with
renal or liver function
impairment; also the elderly
NSAIDS not recommended in cases of advanced
kidney disease
Feldene -piroxicam, Mobic-meloxicam
metabolites may contribute
to kidney stones; keep hydrated
Clinoril-sulindac
Nausea, fatigue, lethargy, pruritis, jaundice, upper
right quadrant tenderness, flu-like symptoms are signs of
hepatotoxicity
Black Box Warning
For short term (up to 5 days) only
For moderate-severe pain
High risk of GI effects and Renal effects
Toradol
should be avoided within 2-3 hours of the
Aspirin dose
NSAIDS (non-specific)
schedule of Hydrocodone products
CIII
All codeine, oxycodone and hydrocodone products are immediate release except
OxyIR
narcotic also available as injection and lozenge
fentayl
Dolophine
methadone
narcotic; immediate release tablets and injection;
also available in solution and powder
methadone
Contraindications:
Acute or severe bronchial asthma
Upper airway obstruction
Significant respiratory depression
Premature infants
When delivery of a premature infant is anticipated
narcotic agonists
narcotics with suicidal implications
darvon, darvocet
Oxycodone is category
B
Do appear in breast milk, but effect may not be significant
Recommend to wait 4-6 hrs after use before breast feeding
narcotic agonists
Fentanyl
Black Box Warning:
Hypoventilation
Duragesic Patch: Start at lowest dose…particularly elderly d/t
muscle wasting and poor fat stores
If use is required for more than 3 weeks, oral form can be dispensed at an approved maintenance program only
methadone
narcotic agonist potentially inappropriate in the elderly
Darvon, Darvocet
morphine precaution
seizures
Most patients who receive opiates for medical
reasons do not develop
dependence
Cigarette smoking may decrease pain relief from
Darvon, Darvocet-propoxyphene
two drugs which interact with Darvon, Darvocet-propoxyphene
Tegretol and anticoags
drug interaction with morphine
anticoags
for spasticity from multiple
sclerosis, spinal cord injury, other spinal cord
diseases
Lioresal- baclofen
for muscle spasticity
Zanaflex - tizanidine
Because of similarities to tricyclic
antidepressants, consider all interactions
listed for tricyclic antidepressants
flexeril
hyperpyretic crisis, severe
convusions, and death have occurred in patients receiving tricyclic
antidepressants and
MAOIs
__ may cause dry mouth (especially __)
skeletal muscle relaxants, flexeril
Orally, start low and titrate up to therapuetic dose
* Abrupt withdrawal can result in hallucinations and seizures
baclofen
Intrathecal, screening phase with bolus dose before implant pump
* Abrupt discontinuation can result in high fever, altered
mental status, rebound spasticity, muscle rigidity
baclofen
CAUTION in patients with psychotic features…can worsen
baclofen
Like Baclofen, start at low, sub-therapeutic dose to determine
intolerance, then titrate up to therapeutic dose range
zanaflex
Drowsiness, Dizzyness, Somnolence, Dry Mouth
zanaflex
Hypotension... caution with other alpha-adrenergic agonists (ie: Clonidine)
zanaflex
Possible idiosyncratic Hypersensitivity
- Weakness, Disorientation, Confusion, Agitation
soma
Skeletal muscle relaxants available injection as well as oral
Robaxin and Norflex
Structurally related to tricyclic antidepressants…so higher incidence of drug
interactions on anticholinergic effects
flexeril
Known practically as the least sedating muscle relaxant
- Caution in hepatic impairment
skelaxin
for cluster headache
Imitrex-sumatriptan
injection only
Class of:
Maxalt
Zomig
Frova
Relpax
Amerge
Axert
Serotonin 5-HT1 Receptor Agonists
May discolor urine brown, black, or green
robaxin
category for flexeril
B
Insomnia (specific agents)
Restoril, Halcion, Dalmane
Klonopin, Valium, Tranxene, Ativan (IV)
seizures
Librium, Klonopin, Tranxene, Valium,
Dalmane; long or short?
long
Ativan, Xanax, Restoril, Halcion; long or short
short