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23 Cards in this Set

  • Front
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Local anesthetics
capsaicin, lidocaine
Antidepressants
TCAs, NSRIs, buproprion
Anticonvulsants
gabapentin, pregabalin, carbamazepine
Steroids
prednisone
Alpha 2 agonists
clonidine, tizanidine
Triptans
somatriptan
NMDA antagonists
dextromethorphan, ketamine, amantadine, memantine
Opioids: strong agonist
morphine, hydromorphone, tapentadol, meperidine, methadone, fentanyl, sulfentanil
Opioids: moderate/weak agonist
codeine, hydrocodone and oxycodone with acetaminophen
Opioids: atypical
tramadol, dextromethorphan
Opioids: partial agonist
buprenorphine
Opioids: mixed agonist antagonist
pentazocine
Opioid antagonist
naloxone (IV or intranasal), naltrexone (oral or sublingual), methylnaltrexone
Local anesthetics
Lidocaine - MOA: slow the rapid firing of Na+ channels
Capsaicin - MOA: May damage nerve endings, reduces their ability to send pain signals, that takes time to return to normal function
TCA (first generation)
MOA: Alter neuronal sprouting
SE: daytime sleepiness, cognitive changes, dry mouth, orthostatic HTN
Anticonvulsants
MOA: blocks alpha-2-delta subunit of Ca2+ channels, inhibits release of substance P and glutamate
SE: dizziness and sedation
Opioids - agonists
MOA: reduces excitatory neuronal activity
SE: sedation, confusion, respiratory depression, pruritis, nausea and vomiting, tolerance
Acetaminophen, ASA, NSAIDS
MOA: centrally to block TRPV1 (vallinoid receptors) and as COX inhibitor in the spinal cord and brain
MOA: irreversibly blocks cyclooxygenase required to produce prostaglandins and thromboxane
MOA: reversibly inhibit COX enzymes and inhibit the production of prostaglandins
Neurotransmitters
– endorphins – mu receptors
– enkephalins – delta receptors
– dynorphin – kappa, bradykinin and NMDA receptors
– nociceptin - ORL1 role in anxiety and depression
Morphine
CAUSES MIOSIS
Meperidine
MOA: Increases serotonin
NOTE: metabolite appears to cause some tremors and delerium in susceptible people.
Can accumulate in those with kidney dysfunction.
Not recommended for management of chronic pain. Used in severe pain limited to 48 hours.
CI: DO NOT USE WITH DRUGS THAT INCREASE 5-HT
Methadone
may accumulate in tissues
CI for opioids
• Acute psychiatric instability, suicidality
• Current substance abuse that could have a
negative drug drug interaction
• Drug-drug interactions: meperidine and
MAOIs, methadone and benzodiazepine, any
in combination with alcohol, fentanyl and
CYP 3A4 inhibitors
• Active diversion of controlled substance
• QTc interval >500msec for methadone use