DRUG: AntiConvulsants DRUG: Opioid Analgesics

Carbamazepine (tegretol, carbapsy, tegrepin), Lidocaine(Lidoderm, Enducaine, Lygnonex, Eletriptan (Belpax), rizatriptan (maxalt), Butorphanol(Stadol), Codeine(Codeine, Codipront N), Fentanyl Antipyretics Generic Trade Comments gabapentin (Neurontin, calmpent, gabalept), Nobucaine, Xylocaine) Sumatriptan (lmitrex, Imigran, Sumigran) Citrate(Sublimaze, Duragesic, Sublimax, Tofentyl), Hydrocodone Salicylates and other NSAIDs Acetaminophen Name Name lamotigrine (lamictal) USES: USES: (Lorcet) w/ acetaminophen (Lortab, VIcodin) Hydromorphone (Dilaudid, (Tylenol) Naloxone Narcan Used in the t USES: Used Effective in treating the nausea and vomiting Jurnista), Meperidine (Demerol), Methadone (Dolophine), Morphine to management of postherpetic neuralgia, USES: treatment of Used for the management of nerve pain associated although associated with migraines becausein the treatment Sulfate(Morphine, MS Contin SR), Oxycodone (Oxycontin, Roxicodone) it can provide significant analgesia in Used extensively serotonin opioid receptors are also found in the GI tract. Indicated of mild to with neuralgia, herpes zoster (shingles), and other forms of neuropathic pain, including diabetic w/ Aspirin(Percodan), w/ Acetaminophen(Tylox,Percocet), moderate pain and overdoses in acute treatment of migraines fever. cancer. Implemented when the patient HCl(Darvon) w/ neuropathy and musculoskeletal pain such as for the in adults and Pentazocine(Talwin-NX), Propoxyphene describes ACTION: the delivery no therapeutic value for the prophylactic the pain as sharp, shooting, shcok0like pain, osteoarthritis and low back pain. have Acetaminophen(darvocet) room and Relieves pain by inhibiting prostaglandin synthesis and lightning-like. Neurontin is generally management of migraine headaches USES: ACTION: newborn at the CNS but does not have ant-inflammatory considered first-line anticonvulsant Used for theapurpose of relieving pain for neurotic ACTION: Provides pain relief through a peripheral effect and nursery for action because of its minimal effect on peripheral pain therapy, followed by tegretol and lamictal. generally has little effect if any central action Responsible for vasoconstriction and reduction of ACTION: opiate-induced prostaglandin synthesis. ACTION: inflammation associated with antidromic neuronal Provides relief by blocking the ascending pain pathways by binding to SIDE EFFECTS: respiratory SIDE EFFECTS: Act on sodium channels the CNS altering pain perception and transmission opiate receptors found into stabilize the neuronal Erythema, Edene and hives, allergic reactions depression. Severe liver toxicity, Renal insufficiency, Rash or membrane also helps suppress cough by of response. It and may decrease the release direct action in the CONTRAINDICATIONS: medulla. Naltrexone Revia To treat SIDE EFFECTS: opiate urticarial, blood dyscracias excitatory neurotransmitters. SIDE EFFECTS: Malaise, fatigue, dizziness, drowsiness, Nausea, and alcohol Sensitivity to local anesthetics, Hepatic disease, CONTRAINDICATIONS: Sedation, Confusion, Euphoria, Restlessness and agitation, headache SIDE EFFECTS: vomiting, diarrhea, Asthenia, tingling, paresthesias, dependence Non-intact skin Contraindicated for repeated administration with and dizziness, hypotension and bradycardia, Urinary retention, Sedation, dizziness, and confusion, fushing, pain or pressure in the chest, neck or jaw, CAUTIONS: anemia, cardic or asthmatic Nausea/vomiting and constipation, Respiratory depression, Physical nausea,vomiting, constipation and anorexia, arrhythmias, angina, palpitations, myocardial conditions, renal or Naltrexone is used only after withdrawal from hepatic and/or emotionalunsteadiness, Blurred vision, Seizures with large hypotenson and dependence, hepatitis, rash, infarction, cardiac arrest. disease. opiates, such as heroin and morphine, to help avoid CAUTIONS: dose, Flushing, rash and pruritus marrow steven-johnson syndrome, bone CONTRAINDICATIONS: relapses, it acts by robbing the drugs of their Must be used with frequent acetaminophen use and suppression, nystagmus, diplopia, and blurred CONTRAINDICATIONS: Patients pleasurable effects. It given to someone currently with cerebrovascular or cardiovascular alcohol ingestion because of potential liver damage. vision, gingivitis Head injury, Cardiac Disease, hypotension, CNS depression, Hepatic, disease, hepatic or renal disease, use in older dependent on opiates, it can send the addict Caution also with pregnancy and breast feeding. Renal and thyroid disease, COPD, asthma, Pregnancy, Lactation and CONTRAINDICATIONS: adults, instantly into severe, live-threatening withdrawal. pregnancy, lactation and use in children. Pediatrics, older adults and debilitated, pregnancy,prone, suicidal and Hypersensitivity, psychiatric conditions, Addiction

DRUG: Local Anesthesthetic Antagonists DRUG: Opioid

DRUG: AntiMigraine Nonopioid Analgesic and DRUG:

DRUG: NonBarbiturates DRUG: Nonopioid Analgesics and Antipyretics

Chloral Hydrate, Estazolam(Prosom), [ASA] (Aceprin, Asaprinm Salicylates and other NSAIDs aspirinFlurozepam Antipyretics (dalmane), temazepam (restoril), Trialzolam - potential for physical and psychological dependence and tolerance Aspen, Astrix, Bayer Aspirin) Salicylates and other NSAIDs Tramadol (ultram, (halcion), w/ opiods, sedatives and hypnotics Dolmal, Dolpaz, Milador) Amaryll, Clomadol, USES: Zolpidem(Ambien, stillfnox, zichex, zoldem), Zoleplon (sonata) - taking only limited doses for short periods of time, except to relive Treatment of mild to moderate pain. USES: USES: pain, in terminal illness(in terminal cases, analgesic should be given on ACTION: Used for moderate to severe pain. a regular These agents are used as sedatve-hypnotics to Relieves pain by and reduces inflammation by inhibitions of peripheral basis around the clock to prevent or control pain) ACTION: produce sleep. Chloral hydrate is also used as - caution w/ interaction ; not taking any medications (except under prostaglandin synthesis. Tramadol is centrally acting synthetic analgesics sedative for diagnostic procedures. close medical supervision) that potentiate CNS depression (e.g. SIDE EFFECTS: compound similar in effect to the opioids, but is psychotropics, alcohol, muscle relaxants, antihistamines, antiemetics, ACTION bleeding time, Bleeding and frequent bruising gastric Prolonged : chemically unrelated. It is cardiac medication, and antihypertensives) nonopioids and is not a All have ulceration variable effects on REM sleep, distress, somewhat and bleeding, Tinnitus and hearing loss with controlled substance. It produces overdose of - serious potential side effects w/ prolonged use oranalgesia by opiods, development of tolerance, and Renal insufficiency, overdose, Hepatic Dysfunction, rebound REM sleep decreased urine inhibiting oversedation, norepinephrine and sdatives and hypnotics (e.g.the reuptake ofdizziness, head ache, and insomnia. output with sodium and water retention, renal failure, Drowsiness, serotonin. confusion, agitation, nausea, constipation, urinary retention, and SIDE EFFECTS: dizziness, headache, sweating, euphoria, depression, Rash, Coma, SIDE EFFECTS: potentially fatal respiratory depression, bradycardia, or hypotension) respiratory failure or anaphylaxis w/c can result from hypersensitivity nausea, vomiting, diarrhea, rash, dizziness, ataxia, Dizziness, somnolence, malaise, headache, Nausea, or overdosage especially symptoms. (chloral dependence, withdrawal with children, GI symptoms, Poisoning. tolerance w/ prolonged use, w/ increasingly larger doses required to constipation, sweating and pruritus, orthostatic achive the same effect hydrate): daytime sedation, confusion, and CONTRAINDICATIONS: hypotension, anxiety, confusion, Rash, allergic potential for overdose of sedatives or hypnotics and paradoxical headache-hangover effect, increased risk in GI ulcer and bleeding, bleeding disordersof patients taking reactions w/ older reaction. adults (e.g. confusion, agitation, hallucinations, fall( especially in older adults or w/ long acting anticoagulants, Asthma, Children younger than 15 with influenzahyperexcitability CONTRAINDICATIONS: hypnotics, dependence/withdrawalVit. K deficiency, Allergy to ASA. symptoms, like illness, Pregnancy, Lactation, Increased intracranial pressure or head injury, renal amnesia, hallucinations, bizarre behavior may occur CAUTIONS: and hepatic disease, seizure disorders, pregnant or more often w/ triazolam (Halcon) than w/ Hodgkins Disease, Anemia, Hepatic Disease, Renal Disease,other nursing women, children under 16, abrupt benzodiazepines Pre/postoperatively discontinuation, opiate agonist hypersensitivity.

Patient education: Nonopioid Analgesic and DRUG:

DRUG: Tricyclic Antidepressants

Amitriptyline (Elavil), Nortriptyline (pamelor), Imipramine (Tofranil)

USES:

Used in the treatment of nerve pain associated with herpes, arthritis, diabetes and cancer, migraine or tension headaches, insomnia and depression

ACTION:

Increasing available norepinephrine and serotonin which blocks pain transmission

SIDE EFFECTS:

Dry mouth, urinary rentention, delirium, constipation, Sedation, Orthostatic hypotension, Tachyarrhythmias, Heart block in cardiac patients, the degree of side effects varies with each antidepressants. Side effects may be additive with opioids.

CONTRAINDICATIONS:

CONTRAINDICATIONS:

Caution with tricyclics if used with prostatic hypertrophy, urinary retention, increased intraocular pressure and glaucoma. Contraindications for tricyclics with hypersensitivity and recovery phase of myocardial infarction.

hypersensitivity,severe liver impairment,