Pain 2: Pca & Oa/ra Treatment - Pharmacology

Front 1

PCA

Back 1

Patient Controlled Analgesia

Front 2

3 cons of PCA

Back 2

1) User error
2) Nurse/operator error
3) Mechanical failure

Front 3

Benefit of PCA?

Back 3

Better control over analgesia. Smaller doses with greater frequency allows one to stay pain free and out of sedation

Front 4

Loading dose

Back 4

Initial large dose

Front 5

Demand dose

Back 5

Dose that the pt requests

Front 6

Lockout interval

Back 6

mandatory time between doses

Front 7

1- and 4-hr limits

Back 7

Maximum amount of drug receivable in a given amount of time

Front 8

Background infusion rates

Back 8

Amount of drug continuously administered

Front 9

Drugs used for PCA?

Back 9

1) Opioid or combination
2) Local anesthetic + opioid
3) Anesthetic

Front 10

4 forms of PCA delivery?

Back 10

1) IV
2) Epidural
3) Intrathecal
4) Transdermal

Front 11

Rheumatoid Arthritis

Back 11

Chronic, systemic disorder characterised by synovitis and articular tissue destruction

Front 12

s/s of RA?

Back 12

1) Pain
2) Swelling
3) Stiffness

Front 13

Typical joints affected by RA?

Back 13

Wrist, hands, feet, ankle

Front 14

Etiology of RA?

Back 14

Autoimmune

Front 15

Goals of RA treatment?

Back 15

1) Decrease inflammation
2) Stop progression

Front 16

DMARDs?

Back 16

Disease Modifying Anti-Rheumatic Drugs

Front 17

What, in general, do DMARDs do?

Back 17

Immune suppression

Front 18

Two drugs used in Tx of RA to decrease inflammation?

Back 18

1) NSAIDS
2) Glucocorticoids

Front 19

Timeframe for DMARDs?

Back 19

Slow-acting. Take 6wks to 6mos to see a response.

Front 20

Possible sideE of DMARDs?

Back 20

Liver and kidney toxicity

Front 21

Methorexate brand name?

Back 21

Rheumatrex

Front 22

Anticancer drug used for RA Tx?

Back 22

Methotrexate (Rheumatrex)

Front 23

Azathioprine brand name?

Back 23

Imuran

Front 24

Immunosuppressant drug used for RA Tx?

Back 24

Azathioprine (Imuran)

Front 25

Anti-inflammatory drug used if others are ineffective?

Back 25

Gold compounds

Front 26

Why is using gold compounds avoided?

Back 26

High rates of toxicity

Front 27

"newer" anti-inflammatory for treating RA?

Back 27

Infliximab (Remicade)

Front 28

Brand name for Infliximab?

Back 28

Remicade

Front 29

How does infliximab work?

Back 29

Attaches to the key of TNF-alpha which disrupts the lock-and-key mechanism for TNF-a and it's associated inflammatory response

Front 30

Which RA drug tends to elicit flu-like symptoms?

Back 30

Azathioprine

Front 31

Cause of OA?

Back 31

1) Overuse
2) Bad mechanics

Front 32

Typical joints affected by OA?

Back 32

WBing joints

Front 33

When would you use NSAIDS for OA?

Back 33

When you are in an inflammatory flare-up

Front 34

Potential disease-modifying OA drugs?

Back 34

1) Viscosupplementation
2) Precursors to joint tissue constituents

Front 35

Substrate of cartilage production?

Back 35

Glucosamine