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Pain Meds 2
| Question | Answer |
|---|---|
| What is pain threshold? | amount of a painful stimulus required to perceive as pain |
| What is pain tolerance ? | amount of pain a person is willing to endure |
| Action of opioid analgesics | bind with opiate receptors in CNS to alter the perception of pain |
| adverse affects of opioid analgesics | "constipation, nausea and vomiting, respiratory/circulatory depression, urinary retention " |
| action of opioid antagonists | "blocks opiate receptors, used to treat overdoses (Narcan) " |
| what drug is used to reverse overdoes? | Narcan |
| action of non-opioid analgesics | inhibit prostaglandin synthesis |
| adverse effects of non-opioid analgesics | "GI upset, GI bleeding, Tinnitus, liver/kidney toxicity " |
| routes of administration | "oral, rectal, intramuscular, subcutaneous, intravenous, transdermal/transmucousal, intraspinal, nerve blockers, epidural " |
| methods of administration | "nurse administered analgesia (scheduled or prn), pt controlled analgesia (PCA), epidural catheters " |
| Non-narcotic analgesics | "aspirin, acetaminophen (tylenol), NSAIDS (ibuprofen) " |
| Narcotic analgesics | "opioid agonists methadone, meperidine, propoxyphene, fentanyl " |
| opioid side effects | "confusion, N/V, constipation, sedation, agitation, anxiety, fatigue, headaches " |
| NSAIDS | work at peripheral receptor sites |
| COX2 Inhibitors benefits over COX1 | "Benefits are generally more effective than NSAIDs, better tolerated than NSAIDs, Fewer GI side effects, no gastric bleeding" |
| Morphine is used for: | mod to sever pain |
| Narcotic Agonists (Opioids) | Meperdine (Demerol) |
| Narcotic Agonists-Antagonist | "... increasing side effects of narcotic, even less likely to develop an addiction than wih opiates. " |
| Narcotic Agonists-Antagonist | "Examples: Stadol, Buprenex. " |
| Narcotic Antagonist | (blocks the action of opiates) Narcan : administer if resp. rate falls below 8-9/minute |
| When are COX-2 contraindicated? | Contraindicated for people who have ASA allergies or history of GI bleeding. |
| morphine side effects | "ide Effects: Respiratory Depression, Depressed Coughing, Sedation/Delirium, Nausea & Vomiting, Decreased Peristalsis/Constipation, Hypotension " |
| What is the prototype for NSAIDS? | "Aspirin, Non-steroidal and Asiprin-like meds" |
| Result of platlet inhibitor? | Increased bleeding |
| NSAIDS that reduce fever? | "Asprin, Tylenol, ibprophen" |
| Actions of Asceylsalicylic Acid? | "Decrease chances of ulcer, bleeding, GI irritation; anti-inflammatory, antiplatlet and antipyretic" |
| ASA theraputic level? | 15-30 |
| ASA Toxic Level | Over 30 |
| ASA sever toxicity level? | Over 50 |
| Acetylsalicylic acid (Aspirin) interactions? | "Anticoag, Insulins/antidiabetics, corticosertoids" |
| what salicylates labs would be increased | "PT, PTT, INR and Uric Acid" |
| Decreased Salicylate labs? | "potassium, cholesterol, T3 and T4" |
| What would altered labs for a patient on Salicylates look like? | increased bleeding |
| Foods to avoid on long term salicylate admi? | "prunes, raisins, licorice, certain spices" |
| Teaching for Salicylate patients? | "No alcohol; tell dentist prior to procedures; take with food; Avoid concurrent usage with other anticoags, not for kids-Ryes syndrome; do not use in 3rd trimester of pregnancy; monitor PT, PTT, INR" |
| Salicylate side effects | "tinnitus,dizzy confusion, drowziness, gi upset, peptic ulcer, throbocytompenia,, leukopenia, agranulocytosis, hepetatoxicity" |
| Salicylate toxicity signs? | "Hypersenesitvity-tinnitus, dizzy, bronchospasm; Salicylixm-HA confusion, sweating, sleepy, thirst N/V/D;" |
| What does sever toxicity look like? | "convulsions, cardiovascular collaps, coma" |
| nursing process for salicylates: Asprin | "Med hx; monitor serum level/theraputic range; s/s bleeding , petechiae, ecchymosis, purpura" |
| Nursing: Ibuprofen | "Asses allergies to NSAID, Drug and herbal hx: warfarin, phenytoin and sulfameds interact; monitor bleeding, GI discomfort v/s and monitor for edema-especially AM" |
| Teaching : Ibuprofen | take with food; do not take with aspirin or acetaminophen; avoid alcohol; instruct what herbal meds to avoid; tell dentist/surgeon: do not take while pregnant |
| Indomethacin | antirheumatic; nonsteroidal anti-inflammatory agent |
| Indomethacin-indications | "inflammatory disorders: RA, Osteoarthritis, Mild to Mod pain" |
| Indomethacin-meds to avoid | "Protien bound meds: Aspirin, NSAIDs, corticosteroids" |
| Indomethacin-S/E | sodium and H2O retention; increased BP; edema |
| Indomethacin-teaching | "take with food; remain upright for 15-30min; avoid alcohol, Warfarin, sulfa drugs, phenytoin, aspirin, NSSAIDs, acetaminophen wear sun screen" |
| Indomethacin-Adverse effects | "rash, itching, chills, fever, muscle aches, vision problems, weight gain, edema, abd pain, black stools or persistent HA" |
| Why do you use ketorolac | short term pain relief |
| Propionic acid (Ibuprofen) s/e | "anorexia, n/v/d, edema, rash, purpura, tinnitus, fatique, dizzy, anxiety, confusion, retention" |
| Propionic acid (Ibuprofen) Adverse effects | "Gi Bleeding, blood dyscrasis, dysrhythmias, nephrotoxicity, anaphylaxis" |
| Propionic acid (Ibuprofen)-contraindications | "renall/hepatic disease, asthma, peptic ulcer, anticoag usage" |
| Advantage of Propionic Acid (Ibuprofen) | stronger effects with less GI upset |
| Fenamate hx investigation? | previous peptic ulcer drug usage |
| Who should use Piroxicam? | patients with long term arthritis |
| Why choose Proxicam over other meds? | Longer ½ life and taken once a day; tolerated better than other arthritis meds |
| S/E of Celecoxib | "N/V/D, peripheral edema, HA, dizzy, glatulance, sinusitis" |
| Teaching: Celecoxib | "increase fluids, adhear to dosage, call MD; abd pain, black tarry stools, skin rash, unexplained weight gain, edema, chest pain or s/s hepatoxicity; notify HPC if pregnant" |
| Nursing assesment for Celecoxib | "asses ROM; allergies; lab: AST, ALT, BUN" |
Created by:
sparker77
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