DRUG
NOTES
MOA
DOSAGE
Acetaminophen
- most prescribed SAFEST - analgesic effect only (not anti-inflammatory) - generally used in conjunction with another analgesic for oral surgery
Unknown
Mx daily dose of 4g
Aspirin
- Anti-inflammatory benefits
works peripherally by inhibiting prostaglandin synthesis
max daily dose of 4g - doses of 500-1000 mg shown to be effective
Negative - gastric upset - tags platelets 4-7 days, causing increased post op bleeding - ALLERGY MORE COMMON than with other NSAIDS - Can be fatal if given to children with or recovering from flu or chickenpox. Don始t give to kids under 12 NSAIDS - Ibp, motrin, Naprosyn, etc
- Most effective if given 1 hr prior to surgery - DO NOT USE in 3rd trimester - increased post operative bleeding
- blocking effect of cycloxygenase COX1/COX2, decreasing the conversion of arachiodonic acid to prostaglandin (PG is potent inflammatory mediator) - blocks effects of Thromboxane A2 (platelet aggregation)
Max daily 3.2 g 400mg q4h 600mg q6h 800mg q8h - continue 36-48 hrs post op - if not sufficient, add narcotic analgesic, alternating intake every 2 hrs.
Codeine (Narcotics)
- Tylenol 3 = 30mg Codeine, 300 mg acetaminophen T4=60, T2=15, T1=7.5
centrally acting causing euphoria, nausea, sedation, RESPIRATORY DEPRESSION (careful w COPD)
Max daily dose = 360 mg codeine
Other Narcotics - Oxycodone = Percocet (tylenol) or Percodan (aspirin) - Hydrocodon = Vicodin or Lortab - Propoxyphene = Darvon or Darvocet - Meperidine = Demerol - Tramadol = Ultram - Vicoprofen = IBF + hydrocodon
If allergic to codeine, give Darvocet or Demerol