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Analgesics
| Question | Answer |
|---|---|
| Analgesic Antipyretic | pain reliever fever reducer |
| Endorphins Hypnotic Sedative | internal, natural pain relievers induces sleep a calming agent |
| Anxiolytic | anxiety reliever |
| Narcotic | drug made from opium some controlled substances like cocaine are not opiates |
| Tolerance | Continued higher dosages are required to reach the same response or the same amount of pain relief |
| Dependency | Habit forming properties of a drug Desire for continued use Note: developing a tolerance does not have to mean dependency is forming. |
| The three Non-narcotic analgesics are: | 1) ASA (aspirin)also useful as an antiplatelet 2) Tylenol (acetaminophen) -liver probs if abused 3)NSAIDs (non-steroidal anti inflammatory) ie. Advil, Motrin, ibuprofen no abuse potential but hard on GI tract |
| Describe the Non-narcotic analgesic: ASPIRIN | -analgesic, antipyretic, anti-platelet |
| What kind of complication is possible with Aspirin? | Reyes syndrome; is associated with Salicylates. Tylenol and Ibuprophen do not contain Salicylates. |
| Side effects of Aspirin | GI upset Tinnitis or ringing in the ears |
| Contraindications / caution | GI ulcers Hypersensitivity to product Bleeding disorders Anticoagulant therapy Do not use with NSAIDs-bleeding GI distress |
| Drug interactions | Coumadin (warfarin) –severe hemorrhage NSAIDs-severe bleeding/ulcer |
| Routes of administration for aspirin? What property of aspirin makes it necessary for discontinuing use 1 week prior to elective surgery? | PO Anti platelet effect; Anti-platelet effect is small (81-325 mg) |
| Uses of Tylenol (acetaminophen) | Analgesia for mild to moderate pain Antipyretic |
| Contraindications / precautions of Tylenol (acetominophen) | Liver disease Alcoholism or concurrent alcohol use Never exceed 4000 mg in one day (liver damage may result) Be careful as many OTC/ RX contain acetominophen |
| Tylenol (acetaminophen) Drug interactions | -other hepatotoxic drugs -ok to use while on anticoagulant therapy |
| 3rd Category of nonnarcotic analgesic : NSAIDS | Motrin / Advil (ibuprofen) Rx and OTC Naprosyn / Aleve (naproxen) Rx and OTC Voltaren / (diclofenac) RX only Indocin (indomethacin) Rx only; very potent and used very short term only |
| Four uses for NSAIDS | Analgesic for mild to moderate pain Anti inflammatory; ex. Arthritis Antipyretic Some antiplatelet activity, but not used for its antiplatelet activity |
| Can Ibuprofen and Tylenol be used together? | can be used at the same time now because the mechanism of absorption is different |
| NSAIDs Side effects | GI distress Bleeding |
| Name the Opioid Analgesics (“true narcotics”) | Morphine Codiene |
| Morphine Method of Administration? Class? | Given PO, IM, IV, IV infusion High abuse potential CII classification |
| Codiene Method of Administration? Class? | Less potent than morphine Can be given PO or IM Found in liquid form in cough syrups |
| What are the uses of opioid analgesics? | Analgesic (particularly for relief from chronic pain and from cancer pain) Antitussive (codeine) Antidiarrheal |
| Opioids are dervied from? Dependency rates of opioids? | Poppy plant high dependency Addiction is not usually a problem for patients that require opioids for pain relief. |
| Mechanism of action for opioids? | Attaches to the mu center in the CNS Mimics action of natural pain relievers in the body, such as endorphins |
| Side effects of Opioids? | Confusion Euphoria Hypotension / bradycardia Nausea, vomiting. Constipation Respiratory depression Flushing and rash Physical or emotional dependency |
| Contraindications and cautions Opioid Analgesics | Head injury Increases intracranial pressure CNS depression Hypersensitivity Addiction prone / alcoholism Suicidal individuals |
| Opioid Analgesics Interactions | Psychotropic drugs CNS depressants Sedatives / hypnotics Muscle relaxants Antihistamines Antiemetics |
| Name the Opioid Analgesics? | Duragesic (fentanyl) OxyContin (oxycodone) Percodan (oxycodone/ASA) Percocet (oxycodone/acetaminophen) |
| Is Duragesic (fentanyl)used for acute or chronic pain? | Chronic pain |
| What is the route of admin. for Duragesic (fentanyl) | Via Patch on Skin |
| OxyContin (oxycodone) Route of Admin? | Tablets- that should never be crushed because it becomes 3x powerful! |
| Percodan (oxycodone/ASA) Uses? Schedule? | Used short term, such as for postoperative pain CII controlled substance |
| Percocet (oxycodone/acetaminophen) Uses? Schedule? | For severe pain only High abuse potential CII controlled substance Better choice if bleeding is an issue |
| Darvon/Darvocet (propoxyphene) | Used for moderate pain Has moderate abuse potential Combined with acetaminophen Given PO |
| Vicodin / Lortab (hydrocodone) | Used for moderate to severe pain Moderate to severe abuse potential Combined with acetaminophen Given PO |
| Narcotic Analalogs | Tramadol Stadol (butorphanol) |
| Tramadol | Ultram Ultracet (tramodol / acetaminophen) Caution for those who are allergic to narcotics May cause seizures in those taking SSRIs Caution while taking CNS depressants or other narcotic analgesics Used for mild acute or chronic pain when onset is no |
| Stadol (butorphanol) | Used in place of morphine Used for moderate to severe pain Given as IM or nasal spray; the nasal spray is very habit-forming and people get addicted to it quickly Not recommended for use over extended periods of time |
| Narcotic Antagonists Narcan (naloxone) | An mu receptor antagonist Used to reverse the effects of narcotics Reverses respiratory depression that could be life threatening Will facilitate withdrawal form narcotics Too fast for addicted individuals |
| Non-narcotic Migraine Meds The “triptans” Imitrex (sumatriptan) | Given as injection, oral tablets, or nasal spray To be used only when a clear diagnosis or migraine has been made Works directly on the blood vessels responsible for the migraine |
| Non-narcotic Migraine Meds | Taken at the onset of a migraine headache Safe use of more than four migraine headaches per month has not been established |
| Radiotherapy | Radiation therapy can be administered for the temporary relief from pain from cancer of the bone or from metastases to the bone from another primary malignancy site; palliative treatment, not curative |
Created by:
rjames1029
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