CPJE - Brand/Generic CORRECT 100%
acetaminophen - ANSWER APAP/Tylenol/Ofirmev
PO, IV(undiluted), PR
Fever and pain
MOA: Inhibits prostaglandin synthesis and hypothalamic heat-regulating center
SE: Not common; IV-GI, increase LFTs
Stor/Stab: IV-room temp, use w/n 6hrs
N-acetylcysteine - ANSWER NAC/Acetadote/Cetylev
PO(effervescent,soln) and IV(D5W/SWFI/1/2NS)
APAP Antidote/Mucolytic Agent
MOA: Hematoprotective/glutathione substitute. Mucolytic action by opening disulfide bonds
FDA: 72-hr, 18 dose PO and 21-hr, 3 dose IV regimens
SE: Autoimmune, anaphylaxis, urticaria/pruritis, N/V/GI
Stor/Stab: IV-room temp, use w/n 24hrs-may turn light pink/purple; effer soln use w/n 2 hours of
dissolution
baclofen - ANSWER Lioresal
PO, Intrathecal
Muscle relaxant/antispasmotic
MOA: Inhibits transmission of reflexes at the spinal cord
Dose: Initial: 5mg TID; usual 40-80mg 3-4x/day
SE: Hypotonia, drowsiness, N/V, HoTN
, carisoprodol - ANSWER Soma
PO - Skeletal muscle relaxant
MOA: Not clear - central depressant actions
Dose: 250-350mg TID and qHS for max of 2-3wks
*Long-term use requires a slow taper
SE: Drowsiness, dizziness, HA
cyclobenzaprine - ANSWER Flexeril
PO - Skeletal muscle relaxant
MOA: Centrally acting, related to TCAs, reduces tonic somatic motor activity
Dose: Cap-15mg daily; Tab-5mg TID; max 2-3wks
SE: Drowsiness, dizziness, xerostomia, HA - monitor for s/sx of serotonin syndrome
metaxalone - ANSWER Skelaxin/Metaxall
PO - skeletal muscle relaxant
MOA: General depression of nervous system
Dose: 800mg 3-4x/day
SE: Dizziness, drowsiness, HA, irritability, GI, rash
methocarbamol - ANSWER Robaxin
PO, IV(diluted/undiluted D5W/NS), IM(glutes)
Muscle spasms/tetanus
MOA: General CNS depression
Dose: PO 1.5g 4x/day; IM/IV 1gm q8hr x3days
SE: HoTN, confusion, dizziness, rash, GI
, tizanidine - ANSWER Zanaflex
PO(Cap-can sprinkle on food)
MOA: Alpha2-adrenergic agonist
Dose: Initial 2mg TID; max 36mg; gradual taper off
*CrCl<25-use with caution
SE: HoTN, drowsiness, xerostomia, weakness; Monitor live function
celecoxib - ANSWER Celebrex
PO (can be sprinkled on food)
MOA: COX-2 selective NSAID at higher doses
Dose: 100mg BID or 200mg daily. Higher for gout
*Use not rec in severe renal/hepatic disease
SE: GI, increase LFTs, URTIs
*NSAIDs increase risk of serious CV events
acetylsalicylic acid - ANSWER Aspirin/Ecotren
diclofenac - ANSWER Voltaren DR/Voltaren ER
PO (DR, ER, IR, powder), PR, IV(bolus)
MOA: COX-1 and -2 inhibitor
Dose: 50mg TID, 100mg daily, 37.5mg IV q6hr
*Use not rec in severe renal disease
SE: Edema, HTN, HA, rash, GI
*NSAIDs increase risk of serious CV events
Stor/Stab: IV-protect from light
, diclofenac/misoprostol - ANSWER Arthrotec
PO - OA and RA
MOA: COX-1 and -2 inhibitor; prostaglandin analog
Dose: 50mg/200mcg 3-4x/d
*Give after meal to decrease GI upset
SE: GI, increase ALT
*NSAIDs increase risk of serious CV events
*USE IS CI IN PREGNANT WOMEN*
ibuprofen - ANSWER Motrin/Advil/Caldolor
PO(tab/susp), IV(must be diluted-D5W/NS/LR)
MOA: COX-1 and -2 inhibitor; antipyretic, anti-infla
Dose: 400-800mg q4-6hr; max of 3200mg/d
*Pts should be well hydrates prior to IV admin
SE: Edema, rash, GI, increase LFTs
*NSAIDs increase risk of serious CV events
ketoprofen - ANSWER Orudis
PO(EC, IR, ER), PR
MOA: Cox-1 and -2 inhibitor, antipyretic
Dose: 25-50mg 4x/d, 200mg daily
*max dose of 100mg/d in severe renal impairment
SE: GI, abn LFTs, edema
*NSAIDs increase risk of serious CV events
Stor/Stab: protect from light