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Medicine (MD/DO)
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USMLE Step 2
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Neurology, Ophthalmology & Otology
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Analgesic Agents (Pain Management)

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Neurology, Ophthalmology & Otology | Medicine (MD/DO) School Study Aid

Analgesic Agents (Pain Management)
17 Picmonics to Learn | 25 mins
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
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33 secs
Opioids Overview
Indications
Pain
Weaning
Cough
Diarrhea
Mechanism of Action
Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
Decrease Synaptic Transmission
Side Effects
Respiratory Depression
Addiction
Miosis
Constipation
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2 mins
Acetaminophen-Hydrocodone (Vicodin)
Mechanism of Action
Combination Analgesic
Opioid Receptor Agonist
Hydrocodone
Reversible Inhibition of COX
Acetaminophen
Indication
Moderate to Severe Pain
Side Effects
CNS Depression
Respiratory Depression
Hepatotoxicity
Considerations
Addiction
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2 mins
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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2 mins
Oxycodone
Mechanism of Action
Opioid Receptor Agonist
Indication
Refractory Pain
Side Effects
Respiratory Depression
Constipation
CNS Depression
Considerations
Addiction
Naloxone
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2 mins
Fentanyl
Mechanism of Action
Opioid Receptor Agonist
High Potency
Indications
Anesthesia Induction
Chronic Pain
Breakthrough Pain
Side Effects
CNS Depression
Respiratory Depression
Constipation
Miosis
Considerations
Addiction
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3 mins
Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
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48 secs
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
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2 mins
Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
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2 mins
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
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1 min
Opioid Antidote
Antidote
Naloxone
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29 secs
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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1 min
Gabapentin
Primary Indication
Seizure Treatment
Secondary Indications
Peripheral Neuropathy
Postherpetic Neuralgia
Bipolar Disorder
Migraine Prophylaxis
Characteristics
Inhibits Voltage-Gated Ca2+ channels
Designed as a GABA Analog
Side Effects
Ataxia
Sedation
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2 mins
Pregabalin (Lyrica)
Mechanism
GABA Analog
Indications
Seizures
Neuropathic Pain
Fibromyalgia
Side Effects
Headache
Dizziness
Somnolence (Fatigue)
Weight Gain
Angioedema
Rhabdomyolysis
Considerations
Dependence
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1 min

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