Miscellaneous Pain Medications Medications for Pain & Inflammation ADN 110/cohort 13 1
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ADN 110/cohort 13 1
Miscellaneous Pain Medications
Medications for Pain & Inflammation
ADN 110/cohort 13 2
OVERVIEWO Pain is subjectiveO Result of
O Release of chemical mediatorsO InflammationO pressure
O GoutO Elevated uric acid ->accumulation ->localized
inflammationO Migraine
O Inflammation & vasodilation of cerebral blood vessels
O Local anestheticsO Block motor & sensory neurons
ADN 110/cohort 13 3
ADN 110/cohort 13 4
Anti-gout MedicationO Anti-inflammatory
O ColchicineO Expected action – decrease
inflammationO Therapeutic use – abort, treat, and
decrease incidence of acute attack of gout,
O Other – NSAIDsO Glucocorticoids – used if unable to
take or are unresponsive to NSAIDs
ADN 110/cohort 13 5
Anti-gout MedicationO Hyperuricemia
O AllopurinolO Expected action – inhibit uric acid
productionO Therapeutic use – hyper-uricemia
O Other – febuxstat, probenecid
ADN 110/cohort 13 6
ComplicationsO Colchicine
O GI distressO ThrombocytopeniaO rhabdomyolysis
O ProbenecidO Renal calculi
O AllopurinolO Hypersensitivity reactionO Kidney injuryO HepatitisO GI distress
ADN 110/cohort 13 7
Contraindications/PrecautionsO Colchicine
O Pregnancy risk CO Caution – geriatrics, debilitation, renal,
cardiac, hepatic or gi dysfunctionO Probenecid
O Can precipitate acute goutO Allopurinol
O Pregnancy risk CO Contraindicated – medication
hypersensitivity, idiopathic hemochromatosisO Rhabdomyolysis- statins, impaired kidney &
liver
ADN 110/cohort 13 8
InteractionsO Colchicine
O Grapefruit juiceO Probenecid
O SalicylatesO Allopurinol
O warfarin
ADN 110/cohort 13 9
ADN 110/cohort 13 10
Migraine MedicationsO Acetaminophen,
NSAIDsO Ergot alkaloidsO Serotonin receptor
agonistsO Beta-blockersO AnticonvulsantsO TCAO Calcium channel
blockersO Estrogens
O OtherO Ergot alkaloidsO TriptansO Combination
OTCO Other
combinations
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PurposeO Expected Action
O Prevent inflammation & dilation of the intracranial blood vessels
O Therapeutic UseO Stop a migraine
after it begins or after prodromal manifestations
O Prevention
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ComplicationsO Ergot alkoloids
O GIO Ergotism O Physical dependenceO Fetal abortion
O Contraindications/PrecautionsO Contraindicated – renal &/or liver
dysfunction, hx MI & CAD, pregnancy
ADN 110/cohort 13 13
ComplicationsO Serotonin receptor antagonists
O Chest pressureO Coronary artery vasospasmO Dizziness/vertigo
O Contraindications/PrecautionO Contraindicated – liver failure,
ischemic heart disease, hx MI, uncontrolled HTN, other heart diseases
continued
ADN 110/cohort 13 14
ComplicationsO Beta blockers
O Extreme tiredness, fatigue, depression, asthma exacerbation
O Bradycardia, hypotensionO Complications/Precautions
O Contraindicated - >1st degree heart block, bradycardia, asthma, cardiogenic shock, heart failure
O Caution – WPW syndrome, other antihypertensives, liver or renal impairment, DM
continued
ADN 110/cohort 13 15
ComplicationsO Anticonvulsants
O Neural tube defectsO Liver toxicityO pancreatitis
O Contraindications/PrecautionsO Contraindicated – liver disease,
pregnancy risk D
continued
ADN 110/cohort 13 16
ComplicationsO TCA
O Anticholinergic effectsO Drowsiness, dizziness
O Contraindication/PrecautionsO Contraindicated – recent MI, MOAIs, O Caution – seizure hx, urinary
retention, prostatic hyperplasia, angle closure glaucoma, hyperthyroidism
continued
ADN 110/cohort 13 17
ComplicationsO Calcium channel blockers
O Orthostatic hypotension or bradycardia
O Constipation
O Contraindications/PrecautionsO Contraindicated - >1st degree heart
block, bradycardia, hypotension, left ventricle disease, a-fib/flutter, heart failure
O Caution – liver or renal impairment, ICP
continued
ADN 110/cohort 13 18
InteractionsO Ergotamine & dihydroergotamine
O TriptansO HIV protease inhibitors, antifungals,
macrolide antibioticsO Sumatriptan
O MAOIsO Ergotamine or another triptanO SSRI’s
O PropranololO Verapamil & diltiazemO Diuretics & antihypertensivesO insulin
ADN 110/cohort 13 19
InteractionsO Divalproex
O ASA, chlorpromazine, cimetidineO BenzodiazepinesO Phenobarbital & phenytoin
O AmitriptylineO BarbituratesO CimetidineO MAOIs
O VerapamilO Carbamazepine & digoxinO Atenolol, esmolol, propranolol & timolol
ADN 110/cohort 13 20
Local AnestheticsLidocaineOther
PontacaineNovacainEMLA
ADN 110/cohort 13 21
PurposeO Expected Action
O Block conduction of pain impulses in a circumscribed area
O Therapeutic UseO Dental proceduresO Minor surgical
proceduresO Labor & deliveryO Diagnostic
proceduresO Regional anesthesiaO Skin & mucous
membrane disordersO Minor procedures
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ComplicationsO CNS excitationO Hypotension, cardiosuppressionO Allergic reactionsO Prolonged laborO Fetal – fatal bradycardia & CNS
depressionO Spinal headacheO Urinary retention
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Contraindications/Precautions
O Local anesthetics – pregnancy risk BO Contraindicated – Supraventricular
dysrhythmias &/or heart blockO Caution – liver & kidney dysfunction,
heart failure, myasthenia gravisO Epinephrine – fingers, nose, other
body parts with end arteries
ADN 110/cohort 13 24
InteractionsO Antihypertensive medications
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