PHAR2822 Lecture Notes - Lecture 3: Clonidine, Clomipramine, Triptan
Document Summary
Im/iv not inferior to morphine in moderate postop pain (not severe) Po: 50 100mg q4 6h (cid:523) 400mg d(cid:524) iv: 50 100mg q4 6h (cid:523) 600mg d(cid:524) Doses: vary widely, depend on genetics, phenotype, duration of therapy, status, age. Laxatives must be used (no risk of dependence) Adrs: sedation, constipation, pruritus, respiratory depression, oral health. Naloxone antagonist in od or respiratory depression. Dextropropoxyphene (di-gesic) is not appropriate and must not be used. Nmda receptors, muscarinic receptors, descending monoaminergic pain pathways, voltage- gated ca++channels, -opioid rs in cns. Less respiratory depression (?stimulation), maintains muscle tone, short acting. Incident pain iv: 1 1. 5 mg/kg slowly titrated to effect over 2 5 minutes; then give half dose q10/60. Particularly with confusion, drowsiness or vomiting, or with mild stroke- like symptoms or signs, eg mild hemiparesis, ataxia. History of head injury, particularly with loss of consciousness, or if aevere or prolonged. Triptans (sumatriptan, zolmitriptan, rizatriptan, eletriptan: taken prn, usually once.
