Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
Acetaminophen (Tylenol, Paracetamol, Ofirmev - injectable)
|
Dose forms: oral, chewable, disintegrating, ER, capsule, gelcap, elixir, solution, suspension, suppository, injection PO Dose: 500-650mg q4-6 hrs prn IV Dose (>50 kg): 650mg q4 hrs or 1000mg q 6 hrs Max Dose: 4 g/day Indication: Mild pain Severe Reactions: Hepatotoxicity with excessive dosing Major Drug Interactions: -Carbamazepine: may increase Hepatotoxicity -Ethanol (>3 drinks/day): may increase Hepatotoxicity -Isoniazid: Increase Hepatotoxicity -Phenytoin: increase Hepatotoxicity Contraindications: -Hypersensitivity -Severe hepatic impairment or active liver disease |
|
|
Butalbital with Caffeine and APAP (Fioricet, Zebutal, Dolgic Plus) |
Indication: Headache Dose forms: Tablet, capsule, oral liquid Dose:1-2 q4 hrs Max: Not to exceed 6 tabs/capsules Common Adverse reactions: Drowsiness, depression, nervousness, insomnia, nightmares, nausea Severe ADRs: Hallucinations, hypotension, respiratory/CNS depression, tachycardia, Hepatotoxicity Major DIs: -CNS depressants -Ethanol (>3 drinks/day) -Isoniazid: increase Hepatotoxicity |
|
|
Buprenorphine (Buprenex, Butrans, Subutex) |
Indications: moderate to severe pain, opioid dependence Dose forms: injection, transdermal patch, SL tab Dose: 0.15-0.6 mg q4-8 hrs prn Common ADRs: sedation, hypotension, dizziness, N/V, HA, respiratory depression (IV), constipation, rash (patch) Severe ADRs: respiratory depression, QTc prolongation, Hepatotoxicity, severe allergic rxn Major DIs -CNS depressants- increase sedation and dizziness -CYP3A4 inhibitors and inducers -QTc prolonging drugs -MAOIs- increase sedation |
|
|
Fentanyl (Actiq, Duragesic, Fentora, Sublimaze, Onsolis, Lazanda) |
Indication: Severe pain Dose forms: Patch, Buccal tabs, Buccal film, Buccal lozenge, nasal spray, SL spray, injection Dose: -Patch: 12.5-25 ug q72 hrs (Max 4 patches) -Buccal: 200 ug q 3 hrs -IV: 25-100 ug/1 ug/kg per hr infusion -Epidural: 25-100 ug -Intrathecal: 5-25 ug/dose -Spray: 100 ug/dose/spray Common ADRs: constipation, N/V, sedation, dizziness, xerostomia (dry mouth), pruritis, rash (patch) Severe ADRs: hallucinations, hypotension, respiratory/CNS depression Major DIs: -Amphetamines: increase analgesic effects -Antipsychotics: increase hypotensive effects -CNS depressants: increase sedation and dizziness -MAOIs: serotonin syndrome -Strong CYP3A4 inhibitors: decrease metabolism
|
|
|
Hydromorphone (Dilaudid, Exalgo) |
Indication: Mod-Severe pain, antitussive Dose forms: liquid, IR tab, ER tab, injection, suppository Dose: Initial -Oral: 2-4 mg q4h prn -SQ, IV, IM: 0.2-0.6 mg q2-4 hrs prn -Epidural: 1-1.5 mg bolus; 0.04-0.4 mg/hr Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritis Severe ADRs: Hallucinations, agitation, respiratory and CNS depression Major DIs: -CNS depressants: increase sedation and dizziness/has additive effect -MAOIs, SSRIs: Serotonin syndrome |
|
|
Methadone (Methadose, Dolophine) |
Indication: Severe pain, detox from opiate addiction Dose forms: tab, dispersible tab, injection, oral solution Dose: Initial for pain -Oral: 5 mg q6-8 hrs -IV: 2.5-10 mg q8-12 hrs Initial for addiction -20-30 mg single daily dose Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritus Severe ADRs: Hallucinations, hypotension, respiratory and CNS depression, ECG changes, QT prolongation Major DIs: -CNS depressants -Nonnucleoside reverse transcriptase inhibitors and protease inhibitors: reduce methadone levels -CYP3A4 inducers: reduce levels -CYP3A4 inhibitors: increase levels -St. John's wort: decrease levels -Grapefruit juice: decrease absorption -QT prolonging agents: additive effect -Stavudine and didanosine: decrease bioavailability |
|
|
Morphine (Astramorph, Avinza, Kadian, MS Contin, Oramorph, Roxanol) |
Indication: Mod to severe pain Dose forms: IR/SR tabs, injection, oral soln, suppository Dose: -Oral IR: 10-30 mg q4h prn -Oral SR: 15-30 mg q12h prn -SQ/IV/IM: 2.5 -10 mg q2-4hrs prn -IV/SQ continuous: 0.5-1 mg/hr -Epidural: 5 mg Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritus -Severe ADRs: Hallucinations, hypotension, respiratory and CNS depression Major DIs: -Alcohol: disrupt ER characteristic -CNS depressants -MAOIs/SSRIs: serotonin syndrome |
|
|
Oxycodone (OxyContin, OxyIR, Roxicodone) |
Indication: Mod-severe pain Dose forms: caps, oral liquid, oral concentrate, IR/CR tabs Dose: -IR: 5-15 mg q4-6 hrs prn -CR: 10 mg q 12hrs Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritus Severe ADRs: hallucinations, hypotension, respiratory and CNS depression Major DIs: -CNS depressants -MAOIs/SSRIs: serotonin syndrome |
|
|
Tapentadol (Nucynta, Nucynta ER) |
Indication: Mod-severe pain Dose forms: tab, ER tab Dose: -Acute: 50-100 mg q4-6 hrs prn (Max 700 mg on 1 day and 600 on subsequent days) -Chronic: ER 50 mg q12h (Max 500 mg/day) Common ADRs: sedation, hypotension, dizziness, N/V, constipation, pruritus Severe ADRs: serotonin syndrome, seizure, respiratory depression Major DIs: -Alcohol: enhance CNS depressants effect and increase absorption or ER product -CNS depressants -MAOIs/TCAs/SSRIs: increase risk of seizures and serotonin syndrome -Naloxone: may induce seizure Contraindications: Use of MAOI within 14 days |
|
|
Tramadol (ConZip, Rybix ODT, Ultram, Ultram ER, Ultracet) |
Indication: Mod-severe pain, neuropathic pain Dose forms: IR/ER tab, ODT, combo with APAP Dose: 50 mg q4-6h prn (Max 400 mg/day IR; 300 mg/day ER) Common ADRs: sedation, dizziness, constipation, N/V, somnolence, euphoria/dysphoria Severe ADRs: hypotension, seizures (>500 mg/day) Major DIs: -Carbamazepine: decreases Tramadol levels -MAOIs/TCAs/SSRIs: may increase risk for seizures and serotonin syndrome -Naloxone: may induce seizure -CNS depressants |
|
|
Codeine/APAP (Capital and codeine, Tylenol 2, Tylenol 3, Tylenol 4, Tylenol with codeine) |
Indication: mild-mod pain, antitussive Dose forms: tab, soln Dose: -Antitussive: 15-30 mg codeine q4-6 hrs -Pain: 30-60 mg codeine q4-6 hrs -Max: 4,000 mg APAP/day Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritus Severe ADRs: hallucinations, hypotension, respiratory and CNS depression, Hepatotoxicity Major DIs: -CYP2D6 inhibitors: prevent conversion of codeine to active metabolite morphine -CNS depressants -Ethanol (>3 drinks/day): increase Hepatotoxicity -Isoniazid: increase hepatotoxicity -Warfarin: increased anticoagulant effect |
|
|
Hydrocodone/APAP (Lorcet, Lortab, Norco, Vicodin, Zydone) |
Indication: moderate pain Dose forms: tab, capsule, soln Dose: -Oral: 1-2 q4-6hrs -Soln: 5-10 ml q4-6hrs -Max: 4,000 mg APAP/day Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritus Severe ADRs: hallucinations, hypotension, respiratory and CNS depression, Hepatotoxicity Major DIs: -CNS depressants -Ethanol (>3 drinks/day) increase Hepatotoxicity -Isoniazid: increase hepatotoxicity -Warfarin: increased anticoagulant effect |
|
|
Hydrocodone/Ibuprofen |
Indication: Moderate pain Dose forms: tab Dose: 1 q4-6hrs (Max: 5 tabs/day) Common ADRs: constipation, N/V, sedation, dizziness, xerostomia, pruritus Severe ADRs: hallucinations, hypotension, respiratory and CNS depression, edema, renal impairment, GI bleeding/ulcers, increased BP Major DIs: -CNS depressants -Anticoagulants: enhanced effects -Antihypertensives: decreased effects -Aspirin: Increased bleeding -Lithium: increased conc -MAOIs/SSRIs: serotonin syndrome Contraindications: Asthma, urticaria, or allergic-type reactions to aspirin or NSAIDs; perioperative pain after CABG surgery |
|
|
Oxycodone/APAP (Endocet, Percocet, Roxicet, Tylox) |
Indication: Mod-severe pain Dose forms: capsules, caplet, tab, oral liquid Dose: -Tab: 1-2 q4-6 hrs -Oral soln: 5-10 ml q4-6hrs -Max: 3,000 APAP/day Major DIs: -CNS depressants -Ethanol (>3 drinks/day) increase Hepatotoxicity -Isoniazid: increase hepatotoxicity -Warfarin: increases anticoagulant effect |
|
|
Celecoxib (Celebrex) |
Indication: osteoarthritis, rheumatoid arthritis Dose forms: caps Dose: -Osteoarthritis: 200 mg/day (single or in divided doses) -RA: 100-200 mg bid Most common ADRs: nausea, GI ulcers, peripheral edema, HTN, HA, diarrhea Severe ADRs: GI ulcers/bleeding/perforation, thrombosis (MI, stroke), renal toxicity, exfoliative dermatitis, SJS, toxic epidermal necrolysis, fulminant hepatitis, liver failure, acute renal failure Major DIs: -Antacids: decrease absorption of celecoxib -Corticosteroids: increase GI effects -Ethanol: increase GI irritation -Fluconazole: increase conc of celecoxib -ACE-Is/ARBs: decrease HTN effect and increase renal toxicity -Anticoagulants: increase bleeding risk -Aspirin: increase bleeding risk/diminishes cardioprotective risk -Cyclosporine: increase cyclosporine levels -Diuretics: decreased effects -Lithium: increased conc Contraindications: hypersensitivity to celecoxib, sulfonamides, aspirin, NSAIDs; perioperative pain after CABG surgery |
|
|
Aspirin (Bayer, Bufferin, Ecotrin, Excedrin) |
Indication: mild-mod pain, prevention and treatment of MI, acute ischemic stroke, transient ischemic episodes, stent implantation, adjunctive therapy in revascularization procedures Dose forms: enteric-coated, buffered, chewable, CR tabs, gum, suppository Dose: -Antiplatelet: 50-325 mg daily -Pain and inflammation: Oral: 325-650 mg q4h (Max 4g/day) Rectal: 300-600 mg q4-6h (Max 4g/day) Severe ADRs: Reye's syndrome (children) Major DIs: -Ginkgo biloba: increases Antiplatelet effect -NSAIDs: increases bleeding risk -ACE-Is: diminish antihypertensive effect -Anticoagulants: increase bleeding risk Contraindications: -Hypersensitivity to salicylates or NSAIDs, nasal polyps, bleeding disorders |
|
|
Diclofenac (Flector, Pennsaid, Solaraze, Voltaren) |
Indication: mild-mod pain, dysmenorrhea, osteoarthritis, RA Dose forms: caps, tabs, DR enteric tab, ER tab, topical gel, topical soln, patch, ophthalmic soln Dose: -Analgesia: 50 mg PO TID -Dysmenorrhea: 150-200 mg PO daily in divided doses -RA/osteoarthritis: 150-200 mg/day in divided doses (ER: 100-200 mg daily) Contraindications: hypersensitivity to bovine protein (caps only) |
|
|
Etodolac (Lodine) |
Indication: mild-mod pain, osteoarthritis, RA Dose forms: tabs, caps, ER tabs Dose: -Acute pain: 200-400 mg q6-8 hrs prn (Max: 1000 mg/day) -Osteoarthritis/RA: 400 mg IR bid OR 300 mg IR 2-3 times daily OR 500 mg bid; 400-1,000 mg ER daily |
|
|
Ibuprofen (Motrin, Caldolor, NeoProfen, Advil, Motrin, Excedrin IB, Haltran, Ibuprin, Midol, Nuprin, Pamprin IB, Trendar, Uni-Pro |
Indication: mild-mod pain, acute gout, osteoarthritis, dysmenorrhea Dose forms: tab, chewable tab, oral infant drops, oral suspension, injection Dose -Analgesia: 200-400 mg q4-6 hrs (Max: 1.2 g/day) Severe ADRs: electrolyte imbalances, hemorrhage (injection) |
|
|
Indomethacin (Indocin, Indocin SR) |
Indication: severe osteoarthritis, acute gout, patent ductus arteriosus Dose forms: caps, ER caps, injection, suspension, suppository Dose: -25-50 mg 2-3 times daily (Max 200 mg daily) Contraindications: history of proctitis or recent rectal bleeding (suppository) |
|
|
Ketorolac (Toradol, Sprix, Acular, Acuvail) |
Indication: mod-severe pain, post-op pain Dose forms: tabs, injection, nasal spray, ophthalmic soln Dose: -IM: 60 mg as a single dose or 30 mg q6hrs (Max: 120 mg/day) -IV: 30 mg single dose or 30 mg q6hrs (Max: 120 mg/day) -Oral: 20 mg initial then 10 mg q4-6h (Max 40 mg/day) -Nasal spray: 1 spray in each nostril q6-8hrs up to 4x daily -Ophthalmic: 1 drop qid Contraindications: severe renal impairment, recent or history of GI bleeding/perforation, use before major surgery, suspected or confirmed cerebrovascular bleeding, labor and delivery, breastfeeding |
|
|
Meloxicam (Mobic) |
Indication: osteoarthritis, RA Dose forms: tabs, oral suspension Dose: 7.5 mg daily up to 15 mg |
|
|
Nabumetone (Relafen) |
Indication: Osteoarthritis, RA Dose forms: tabs Dose: 1,000 mg/day (Max: 2,000 mg daily) |
|
|
Naproxen (Aleve, Anaprox, Midol, Naprosyn, Pamprin) |
Indication: mild-mod pain, osteoarthritis, dysmenorrhea Dose forms: tabs, caps, CR tabs, enteric-coated tabs, gel caps, suspension Dose: -Pain: 500 mg then 250 q6-8hrs (Max: 1250 mg/day) -RA/osteoarthritis: 500-1,000 mg/day in divided doses |
