Analgesics - seminar
dosage, adverse/side effects
Pharmaceutical care I., 2018
Martin Šimíček
Analgesics - case reports:
Describe in each prescription:
 Mechanism of Action of prescribed drugs
 Indication for use / dosage
 Adverse / side effects
 Search for contraindications, interactions
 Any special precautions that should be taken
Analgesics:
 What are the types/groups of analgesics you
know?
 What is their mechanism of action?
Paracetamol:
 What is the most serious side effect of
paracetamol?
 What is the safe single/daily dose of paracetamol?
 Against fever/pain. Is there any difference?
Case report 1: adult man, 80kg
Rp: Paralen tbl 10x500mg
(paracetamole)
3x2 daily against pain
 Is it the right dose? For what pain can we use it?
 Is this dosage assocated with risk of overdosage?
 Do you know medicines - combinations of paracetamole?
 How often can it be used? What is maximum daily dose?
NDAIDs
 For what diseases do we use non-steroid antiinflammatory
drugs?
 What kind of symptoms?
NSAIDs - effects
 Describe the two isoforms of cyclooxygenase:
 Constituent/induced - effects in the organism:
Case report 2: Is it the right combination?
Rp:
Aspirin 500mg
(acetylosalicylic acid)
3x1 against pain
Warfarin 5mg
(warfarin)
1x1 according to INR
Case report 3: What are the side effects od NSAIDs?
Rp:
Diclofenac tbl 30x100mg
Exp. Orig No II(duas)
3x1 daily
Omeprazol TEVA 100x20mg
Exp. Orig No II(duas)
2x1
Case report 4: Is it appropriate
combination of drugs?
Rp:
Diclofenac tbl 30x100mg
Exp. Orig No II(duas)
3x1 daily
Prestance 90x10/10mg
Exp. Orig No II(duas)
1-0-0
Case report 5 (osteoarthrosis):
Rp:
Arcoxia 14x60mg
(etoricoxibe) 1x1 daily
Concor COR 28x10mg
(bisoprolol)
1-0-0 daily
Case report 5 (osteoarthrosis):
Rp:
What coxibes do we have on
the market?
What is the route of
administration?
What are the adverse effects
od coxibes?
What are the
contraindications of
coxibes?
Case report 6:
Rp: Aulin tbl 30x100mg
Exp. Orig No III(tres)
(nimesulide)
3x1 daily
osteoarthrosis
Case report 6:
Rp: Aulin tbl 30x100mg
Exp. Orig No III(tres)
(nimesulide)
3x1 daily
osteoarthrosis
Is it the right dosage? What is the maximum daily
dose?
What are the errors in this prescription?
What is the main side effect of nimesulide?
 What analgesics can be used during pregnancy?
Opioids
 Which opioids are used to treat postoperative
pain?
 What are the typical side effects of opioids?
 Which opioids are appropriate for therapy of
chronic pain and why?
 What opiods are categorized as weak opioids/
strong opioids?
Case report 6: Low-back pain
Rp: Tramal ret 10x100mg
(tramadol)
1x1 daily
What is the maximum daily dose?
What is the machanism od action?
What are the typicale side effects od tramadol?
What are the typical combinations od tramadol in
one tablet?
Case report 7:
Rp:
Durogesic emp 50ug/hod
Exp. Orig No II(duas)
each 48hours
Instanyl spray
Exp. Orig No II(duas)
50ug/hod as requierd
Case report 7:
Rp:
Durogesic emp 50ug/hod
Exp. Orig No II(duas)
each 48hours
Instanyl spray
Exp. Orig No II(duas)
50ug/hod as requierd
Dispensation minimum:
Is it the right dosage in this prespription?
What are the important information how to use
transdermal systems and nasal spray with fentanyl?
Neuropathic pain
Can you give us examples od neutopattic pain?
What drugs are used for treating neuropathic
pain?