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PainMedGC17
LPN Pain Medications Goodcare
| Question | Answer |
|---|---|
| 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
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