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Pharm Test 3
Analgesics Ch. 10 lilk8tob by danielle
| Question | Answer |
|---|---|
| what are the three primary opioid pain receptors | Mu, Kappa, Delta |
| Why are adjuvant agents used? | They allow smaller doses of opioids to be used; decreases side effects; have a synergistic effect |
| What is a commonly used adjuvant agent? | NSAIDS; ie: Tylenol |
| What does 'contin' stand for in MS Contin? | Continuous (as in long-acting) |
| Opioids with an affinity for Mu receptors produce ___________ | Euphoria (& are likely to be abused/used recreationally) |
| What is psychological dependence on a drug? | Addiction: compulsive use characterized by a continuous craving/need to use it for effects other than pain relief |
| What is physical dependence on a drug? | The physical adaptation of the body to the presence of an opioid /other addictive substance |
| Signs of physical withdrawl of opioids: | rebound pain, tachycardia, incr. BP, mental agitation |
| Signs of pain in a baby | muscular rigidity, restless, screaming, fear of moving, withdrawn behavior |
| Proper use of a suppository | give exact dose; do not halve/split/divide it |
| With peds/opioids: report these changes to the Dr. immed: | dizzy, lightheaded, drowsy, hallucinations, chng in LOC, sluggish pupil reaction |
| When should opioid be withheld from peds? | When resps are less than 12 per minute or if changes in LOC |
| Signs of allergic rxn to opioids | rash, urticaria |
| Signs of opioid withdrawl | N&V, abd. cramps, anxiety, irritable, hot flashes, chills, joint pain, lacrimation, rhinorrhea, sweating, diarrhea |
| The nurse should monitor _________ with older patients on opioids | vitals, resp. fxn., CNS status |
| ________ should be used with caution in geriatric pts. | NSAIDs-due to renal, hepatic and GI toxicity |
| What causes many of the unwanted side effects of opioids? | Histamine release (all opioids cause it): rash, pruritis, hemodynamic changes, dilation of periph. BVs (ortho. hyptensn) |
| What is the most serious side effect of opioids? | CNS depression, which may lead to resp. depression |
| Who is most at risk for resp. depression with opioids? | COPDer's |
| What is naxalone (Narcan) used for? | To reverse resp. depression; be aware that it also reverses pain relief too |
| GI side effects of opioids | N&V, constipation are the most common, also: urine retention |
| MOA of non-opioids | inhibit prostaglandin synth. and block pain impulses peripherally |
| Tylenol acts on the ______ in the brain to reduce fever | hypthalamus |
| Tylenol is indicated for tx. of ______ | mild-moderate pain and fever |
| SEs of Tylenol | rash, N&V. Rare: blood disorders (anemia) and nephrotox. |
| Ingestion of large amts of Tylenol causes: | hepatic necrosis -most serious acute toxic effect |
| Standard max. daily dose of Tylenol is: | 4000 mg per day |
| Antidote for acetaminophen OD | acetylcysteine-1 initial dose/17 addt'l -need ALL |
| Who is at risk for liver toxicity when taking Tylenol | heavy alcohol abusers |
| Contraind. for taking tylenol | intol. to yellow dye #5, alcohol, sugar, saccharin, anemic, renal/hepatic disease |
| What to assess before giving analgesics | allergies, meds, herbals, alcohol use, pain, vitals |
| Contraind. for using opioids | allergies, asthma, opioid addiction, head injury, incr. intracranial pressure |
| Why is opioid use contraind. in pts. with asthma? | B/c of the unwanted SE of resp. depression, esp. w/ pulm. disorders |
| Why is a head injury a contraind. to opioid use? | B/c they are CNS depressants and eval. of LOC is very difficult w/ head injured pts. |
| Why are PCA Pumps and patches used to administer opioids? | to avoid first pass metabolism |
| What is an advantage to using transdermal patches for pain? | allow multiday therapy with a single application/increases pt. compliance |
| How is Narcan admin? | 0.4-2 mg IV over 15 sec. (may need to readmin. in 1 hr.) |
| Therapeutic effects of analgesics | decr. pain, incr. comfort, impr. ADLs, appetite, sense of well being |
| Monitor for these SEs | N&V, blurred vision, HA, drowsy, lethargy, sedation, bradycardia/bradypnea, dyspnea, shallow resps/<12/min |
Created by:
lilk8tob