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PainMedGC17

LPN Pain Medications Goodcare

QuestionAnswer
Pain perception nociception
where pain is first perceived Pain threshold
person’s ability to endure pain Pain tolerance
Which pain is subdivided into malignant (cancer) and nonmalignant Chronic pain
pain is dull and aching Nociceptive
pain originates from skin, bones, or muscles Somatic
pain originates from abdominal or thoracic areas Visceral
pain results from nerve injury; stabbing and burning Neuropathic
pain nonspecific and of unknown origin Idiopathic
These menstrual cramps are getting worse and worse.” (visceral) “I had a virus a couple months ago, but now everything just hurts.” (idiopathic) Example pain described
“I fell asleep in the back of my brother’s car, and now my shoulder is killing me.” (somatic) “I have a stabbing, shooting pain that runs down my left leg.” (neuropathic) Example pain described
for severe acute pain Opiate agonists—
for unrelieved or moderate acute pain Opiate partial agonists—
for mild acute pain Salicylates—
reverse adverse effects of opiate agonists Opiate antagonists—
for mild acute pain Nonsteroidal anti-inflammatory drugs (NSAIDs)
Antihistamines Prostaglandin inhibitors (NSAIDs) Antidepressants (TCAs and SSRIs) Substance P antagonists (capsaicin) Drugs used to block these chemical that contribute to pain
General comfort measures: backrubs, repositioning, heat/cold applications Relaxation techniques Diversional activities Decreased environmental stimulation Visualization Biofeedback Meditation Transcutaneous electrical nerve stimulation (TENS) uni Nonpharmacologic strategies enhance effects of medications
Syringe pump contains opiate agonist (usually morphine) connected to IV pump, IV catheter Patient self-administers small dose of analgesic Pump limits amount and frequency of dose Provide patient/family teaching Record amount used and degree of pain r Patient-Controlled Analgesia (PCA)
Actions Effective analgesic without prior administration of opiate agonists Pharmacologic action depends on whether an opiate has been previously administered Subject to ceiling effect Prolonged use leads to tolerance Opiate Partial Agonists
Uses Short-term relief (up to 3 weeks) of moderate to severe pain associated with cancer, burns, renal colic; preoperative analgesia, and obstetric and surgical analgesia Opiate Partial Agonists
Drugs Buprenorphine (Buprenex, Subutex) Butorphanol (Stadol) Nalbuphine (Nubain) Pentazocine (Talwin Opiate Partial Agonists
Common adverse effects Clamminess, dizziness, sedation, sweating; nausea, vomiting, dry mouth, constipation Opiate Partial Agonists
Serious adverse effects Confusion, disorientation, hallucinations; respiratory depression; excessive use or abuse Opiate Partial Agonists
Actions Inhibit prostaglandin synthesis Three pharmacologic effects: analgesic, antipyretic, anti-inflammatory Aspirin has unique property of inhibiting platelet aggregation and clotting Salicylates
Uses Discomfort, pain, inflammation, or fever associated with bacterial and viral infections; drug of choice Headaches, muscle aches, rheumatoid arthritis Reduce risk of myocardial infarction, TIA, stroke Salicylates
Drugs Aspirin (ASA, Empirin), diflunisal (Dolobid), magnesium salicylate (Doan’s, Novasal) Salicylates
Common adverse effects GI irritation Salicylates
Serious adverse effects GI bleeding; salicylism (tinnitus, impaired hearing, dimming of vision, sweating, fever, lethargy, dizziness, mental confusion, nausea and vomiting Salicylates
Use in children not recommended due to risk of Reye’s syndrome Salicylates
Increased risk of bleeding in older adults in the form of GI bleeding or a hemorrhagic stroke. Salicylates
No antidote exists for aspirin toxicity; discontinuing the drug is the only treatment and the condition is reversible. Salicylates
acetaminophen (Tylenol) Miscellaneous Analgesics
Actions Synthetic nonopiate; no anti-inflammatory activity acetaminophen (Tylenol)
Uses Fever and pain reduction, therapeutic effects similar to aspirin acetaminophen (Tylenol)
Common adverse effects Gastric irritation acetaminophen (Tylenol)
Serious adverse effects Hepatotoxicity acetaminophen (Tylenol)
Signs of toxicity: anorexia, nausea, vomiting, low blood pressure, confusion, abdominal pain Later signs, jaundice, and increased AST/ALT levels acetaminophen (Tylenol)
Maximum daily adult dose: no more than 4 grams of acetaminophen daily acetaminophen (Tylenol)
Antidote is acetylcysteine acetaminophen (Tylenol)
Examine products containing the following and note dosages of each drug Aspirin and caffeine, aspirin and codeine Aspirin, acetaminophen, and caffeine Acetaminophen, caffeine, and butalbital Aspirin, caffeine, and butalbital Acetaminophen and hydroco Analgesic Combination Products
Actions “Aspirin-like” but unrelated to salicylates Prostaglandin inhibitors Block cyclooxygenase (COX-1 and COX-2) Varying degrees of analgesic, antipyretic, and anti-inflammatory activity NSAIDs
Uses Relief of pain and inflammation from rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout Dysmenorrhea, minor aches and pains NSAIDs
Drugs Diclofenac (Cataflam, Voltaren), etodolac, fenoprofen (Nalfon), flurbiprofen (Ansaid), ibuprofen (Motrin, Advil), others NSAIDs
Common adverse effects Gastric irritation, constipation; dizziness, drowsiness NSAIDs
Serious adverse effects GI bleeding; hepatotoxicity; confusion; hives, pruritus, rash, facial swelling; nephrotoxicity; blood dyscrasias NSAIDs
Increased risk of potentially fatal cardiovascular emergencies (heart attack, stroke) associated with long-term use. Drug interactions: warfarin, phenytoin, valproic acid, lithium, aspirin, furosemide, etc NSAIDs
None are superior to aspirin but are preferred options for patients who do not tolerate aspirin. True or False True
Created by: TutorDavis17