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Pharm Chpt 26
Pharmacology
| Question | Answer |
|---|---|
| Pain is ____ and ____ experience associated with? | is sensory and emotional experience associated with actual or potential tissue damage |
| Drugs used to review pain are? | Narcotics(opium derivatives) and antimigrane drugs |
| Location of Opoid receptors(3) | CNS, nerves in periphery, and cells in GI tract |
| Narcotic agonists act at? in? | act at specific opoid receptor sites in CNS |
| Narcotic Agonists produce? | produce analgesia,sedation, sense of well being |
| Narcotic agonists are for? | for severe acutre or chronic pain, preoperative medication, analgesia during anesthesia, antitussives(cough medicine) |
| Narcotic Agonists crosses the placenta. T/F | True |
| Narcotic agonist most reliable route for therapeutic level is? | IV |
| Contraindications for Narcotic Agonists. | Diarrhea caused by poisons |
| Drug-Drug for Narcotic Agonists | Barbiturate general anesthesia, phenothiazines,MAOIs |
| Narcotic Agonists adverse reactions | Respiratory depression-apnea and cardiac arrest, shock, orthostatic hypotension(BP drops when standing up), NVC(constipation), Dizziness, anxiety, fear, psychoses, hallucinations |
| Example of Narcotic Agonist | Morphine |
| Morphine indication | relief of moderate to severe acute or chronic pain; preop med, component of combo therapy for severe chronic pain |
| Nursing Implications for Morphine | Assess for respiratory depression(with phenothiazines,MAOIs), orthostatic hypotension, NVC, and neurological effects(light headed,dizzy,impaired mental processes, constricted pupils, anxiety and psychosis) |
| Narcotic Agonists-Antagonists act at? in? | act at specific opoid receptor sites in CNS |
| Narcotic Agonists-Antagonists produce? | analgesia and sedation |
| Narcotic Agonists-Antagonists are for? | For moderate to severe pain, adjunct to anesthesia, labor and delivery |
| Examples of Narcotic Agonists-Antagonists | Buprenex,Stadol,Nubain,Talwin |
| Buprenex is for? | for mild to moderate pain |
| Stadol is for? | for moderate to severe pain |
| Stadol is what kind of medication? | is a preop medication |
| Nubain is for? | moderate to severe pain |
| Nubain is adjunct for? | is adjunct for general anesthesia |
| Nubain is used when? | to relieve pain during labor and delivery |
| Talwin is used when? | is used post surgery |
| Cautions for Narcotic Agonists-Antagonists | Physical dependence, COPD and respiratory tract disease, Acute MI or coronary artery disease |
| Adverse reactions for narcotic agonists-antagonists | respiratory depression, NVC, biliary spasm, HA, dizziness, psychosis, anxiety, hallucinations |
| Example of Narcotic Agonist-Antagonist(prototype) | Talwin |
| Nursing Implications for Talwin | -monitor orientation, respirations, cardiac rate and rhythm -safety measures-Bed low, rails up, ambulation assistance -not operate equipment |
| Narcotic Antagonists are used for/when? | Used to reverse narcotics postop and to treat narcotic overdose |
| Narcotic antagonists ____ strongly to? | bind strongly to opoid receptors |
| Do narcotic antagonists activate the opoid receptors? How/Why? | No, they do not activate the opoid receptors, they reverse the effects of opoids |
| Adverse reactions of narcotic antagonists | tachycardia, dysrhythmias, BP changes |
| Drug-drug for narcotic antagonists | buprenorphine(buprenex), butorphanol(Stadol), nulbuphine(Nubain), pentazocine(Talwin), propoxyphene |
| Examples of Narcotic antagonists | Nalmenfence(Revex), Naloxone(Narcan), Naltrexone(ReVia) |
| Revex does what? | reverses effects of narcotics |
| Revex manages? | manages overdose |
| Narcan does what? | reverses adverse effects of narcotics |
| Narcan diagnose what? | diagnose suspected acute narcotic overdose |
| ReVia manages? | manages alcohol or narcotic dependence |
| Available in oral form(Narcotic Antagonists) | ReVia |
| Narcotic Antagonist prototype | Narcan |
| Nursing Implications for Narcotic Antagonists | -very short half life -narcotic withdrawal(NV,sweating,shaking, tachycardia, hypotension, anxiety) -Postop:Tachycardia and hypotension possible(CNS excitement) |
| Types of headaches | Migrane,Cluster,Tension |
| Severe throbbing HA on one side of head | Migrane |
| Begins during sleep | Cluster |
| Sharp,steady eye pain | Cluster |
| Symptoms of Cluster HA | sweating, flushing, tearing, nasal congestion |
| Usually occurs with stress | Tension HA |
| Dull band of pain around entire head | Tension HA |
| Drug families that treat headaches | Ergot Derivatives and Triptans |
| Ergot derivatives block? | block alpha adrenergic and serotonin receptor sites in brain |
| Ergot derivatives cause? | cause constriction of cranial vessels |
| Ergot derivatives- absorption? route? | rapidly absorbed, numerous routes |
| Drug-Drug for ergot derivatives | beta blockers |
| Contraindication for Ergot Derivatives | coronary artery disease,hypertension,peripheral vascular disease |
| Adverse reactions of Ergot derivatives | numbness,tingling,pulselessness, muscle pain, weakness, chest pain, arrhythmias, NVD |
| Example of Ergot derivatives(prototype) | Ergotamine |
| Indication of Ergotamine | prevention or abortion of vascular HAs |
| Ergot Derivatives cautions | pruritis(worsens with vasoconstriction) and malnutrition(stimulate CTZ) |
| Triptans bind to? Causing? | -bind to selective serotonin receptor sites -causes vasoconstriction of cranial nerves |
| Triptans prevent and treat migranes. T/F why? | False, treat migranes but not prevent because they bind to selective serotonin receptor sites |
| Caution of triptans | elderly, CAD, lactation |
| Drug-Drug for Triptans | Ergot containing drugs and MAOIs |
| Triptans adverse reactions | numbness,tingling, burning sensation, feeling of coolness, weakness, dysphasia, BP alterations |
| Prototype for triptans | Sumatriptan(Imitrex) |
| Indication for Imitrex | treatment of acute migrane, treatment of cluster HA |
| Triptans- discontinue _____ when? | discontinue MAOIs 2 weeks before use |
| Triptans- Assess? | Assess numbness and tingling, arrhythmias, and hypertension |
| Give triptans when? | at first start of HA |
Created by:
mhruska
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