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Medications + Complications - Coggle Diagram
Medications + Complications
Acetaminophen Toxicity
When NAPQI > GSH
Risk Factors
Safe dose is exceeded -> Patient self medication with drug abuse
Minor oxidative pathway becomes major
Decreased glutathione stores
Non-alcoholic chronic liver disease
NSAIDs contraindications
Patients with ASA triad (Nasal polyps, asthma exacerbation, angioedema)
Alegy to Sulfa
Active peptic ulcer disease
Congestive Heart Failure
Risks of renal Failure
Renal insufficiency, poorly controlled hypertension, Terrible traid for GFR (Hypovolemia, ARB, NSAIDs)
Risk of non-union in bone surgery or fusion in spine surgery
Tramadol
Strength lies in its weakness as an opioid "poor Mu receptor affinity"
Other mu agonist can be added
CAn lead to serotonergic syndrome if given in combination with other serotonin increasing drugs
How to suspect Opioid Over-dose
Naloxone
Hypoxemia is a medical emergency, hypercarbai is not
Can lead to severe pain, sympathetic response, pulmonary edema, MI, dysrhythmias
Gabapentins
Can be used off label, but caution for over-sedation
Benefits
Good for pain in region of surgery when pronociceptive mehcanisms play a role
Consequences
Mild pain when simple analgesics could suffice, and too large dose in sleep deprived patient can lead to morphone failure
Goal of Pain Management
3/10 at rest, and 5/10 activity
Nociceptive Modulation
Pro-Antinociceptive
Augments inhibitory modulation of nociception
Anti-pronociceptive
Inhibits facilitatory modulation of nociception