All about OA
Can be used as a first line option in mild pain
Acetaminophen (Tylenol)
Lower incidence of TNS compared to lidocaine, but not great for epidurals
Mepivacaine
giving succinylcholine to a patient with cholinesterase deficiency is a bad idea, it could cause this ADR
prolonged paralysis
OA is a polyarticular disease, but is most certainly NOT
autoimmune
GABA → anesthesia, Mu receptor → analgesia
Nicotinic receptors?
skeletal muscle relaxation
ASA is the most nonselective NSAID, while Celecoxib is the the most selective for this enzyme
COX2
effect of local anesthetics on vasculature
Vasodilators
Indicated for spasticity commonly associated with MS, spinal cord injury, etc because of inhibition of reflexes at the spinal cord
Baclofen
radiographic findings of OA
narrowed joint space, bone spurs, bone cysts, increased subchondral bone density
2 categories of neuromuscular blockers
depolarizing or non-depolarizing
Both an anti depressant and analgesic, duloxetine (Cymbalta) is an SNRI used to increased these neurotransmitters centrally
NE & 5HT
2 agents popular in epidural
bupivacaine & ropivacaine
This drug is centrally acting and leads to a reduction in the release of excitatory amino acids like glutamate
and aspartate, which cause neuronal firing that leads to muscle spasm
Tizanidine (zanaflex)
Neuromuscular blockers are all inactive orally, and are instead given in this route
parenterally
Opioids act to close voltage gated Ca2+ channels on this nerve terminal
presynaptic
You have 2 options for intra-articular corticosteroids
(depo-medrol) methylprednisone & (kenalog) triamcinolone
local anesthetic used in spinal anesthesia
tetracaine
In addition to having CNS depressive effects, methocarbinol (robaxin) has this ADR
long acting non-depolarizing neuromuscular blocker
pancuronium
most opioids have this effect on the CV system
bradycardia
Hylauronic acid, chondroitin, and glucosamine all share this common trait
not recommended based on lack of efficacy
benzocaine is highly lipophilic, makes its route of administration limited to this form
topical use only
Metaxalone (skelaxin) is CI in impairment of these organ systems
Liver & renal
This depolarizing neuromuscular agent is great for intubation, as it paralyzes the muscles of the glottis
Succinylcholine
also in an ophthalmic solution for conjunctival inflammation and corneal abrasions.
Indomethacin (indocin)