Pharmacology
Is an opioid receptor agonist and antagonist
What is Bupenorphine?
Produces less constipation than other opioids
What is Fentanyl?
The three best options for CKD (GFR less than 30)
What are fentanyl, methadone and hydromorphone?
Unlike numerical or categorical rating systems, this pain assessment tool relies on a continuous 10-centimeter line, allowing for greater sensitivity in detecting small changes in pain intensity; patients mark their pain level along the line, and the score is measured in millimeters
What is the Visual Analog Scale (VAS) for pain?
This is considered an opioid tolerant patient
What is a patient that has been taking 60 OME for a week or longer?
Metabolizes into oxymorphone and noroxycodone
What is oxycodone?
Accumulation of this metabolite can lead to neurotoxicity
What is M3G?
Long acting options (2) for patients NPO on feeding tubes
What are methadone and fentanyl?
Is the scale that ranks pain from 0-10 according to severity
What is the pain numerical rating scale?
Is the PRN interval for short acting opioid (in absence of liver or renal dysfunction)
What is 3 to 4 hrs?
Metabolizes by non-CYP enzymes into M3G and M6G
Morphine
Sign that always precedes respiratory depression
What is somnolence?
Starting dose for frail, elderly patient, opioid naive with a hip fracture?
What is oxycodone 2.5mg q 4h PRN for moderate to severe pain?
Two instances where fentanyl patch is not recommended
What is Fever (hyperthermia), malnutrition (cachexia), and MRI (bonus)
Requires metabolism by CYP2D6 to become active
What is Codeine?
A side effect to which the body does not develop tolerance
What is constipation?
Best short acting choice for pain control in liver disease
What are hydromorphone and fentanyl?
Is the scale designed to evaluate pain in young and non verbal children using face, legs, activity, cry, and consolability
What is FLACC?
Concomitant use of this medication closes (two) and opioids increase the risk of respiratory depression
What are benzodiazepines and gabapentinoids?
What are oxycodone, fentanyl, hydrocodone, tramadol, and methadone?
Opioid more likely related to histamine release (pruritus)
What is morphine?
These are the five behavioral indicators to evaluate pain in Patients with dementia (PAINAD)
what are treating, negative vocalization, facial expression, body language, consolability?
Is five times more potent than morphine
What is hydromorphone?