Pain - Non-opioids
27 important questions on Pain - Non-opioids
Mild pain (acute or chronic) treatment. What other regimen can it be used in?
Can be added to opioid regimen to reduce total opioid dose required
Acetaminophen reduces pain and fever (antipyretic), but does not provide what?
How does acetaminophen work?
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Acetaminophen + aspirin + caffeine
How do all NSAIDs work?
How do the non-selective NSAIDs work?
How do the COX-2 selective NSAIDs work?
Why do the non-selective NSAIDs cause MORE GI effects?
How does aspirin work?
What risks require all Rx non-aspirin NSAIDs to have a MedGuide?
CV risk: MI, stroke
Coronary Artery Bypass Graft (CABG) surgery: CI after this surgery [antiplatelet: aspirin is recommended]
What NSAIDs can be used within 14 days after birth to close a patent ductus arteriosus (PDA)?
List the COX-1 and 2 non-selective NSAIDs
Indomethacin (Indocin)
Ketorolac (Toradol)
Naproxen (Aleve)
Naproxen + esomeprazole (Vimovo)
Ibuprofen dosing for adults
max: 1.2 g/day
limited to <10 days
Rx: 400-800 mg q6-8h
max: 3.2 g/day
Ibuprofen dosing for pediatrics
max: 40 mg/kg/day
What type of side effects are high risk for indomethacin?
Naproxen OTC dosing for pain and fever
1st dose can take 2 tabs
max: 3 tabs/24 hrs (600 mg)
Which COX-1 and 2 non-selective NSAID may be preferred by prescribers and patients since it can be dosed BID?
Ketorolac BBW and warnings
Increased bleeding, acuet renal failure, liver failure
Ketorolac nasal spray
<65 yrs and >/= 50 kg: 1 spray in EACH nostril q6-8h
>/= 65 yrs or < 50 kg: 1 spray in ONE nostril q6-8h
Which COX-2 selective NSAID has the highest COX-2 selectivity?
Voltaren + misoprostol BBW
Cardioprotective dosing for salicylate NSAIDs
What can be caused by salicylate overdose?
What can be used for GI protection with chronic NSAIDs use?
Side effects of salicylate NSAIDs
How should aspirin for cardioprotection and ibuprofen for pain, be taken together?
What can NSAIDs do to the levels of lithium and methotrexate?
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