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68wm6 p2 pain med

Pain medications

QuestionAnswer
What are the two components pain? *Physical component, the sensation of pain. *Psychological component, emotional response to pain.
What type of pain creates an autonomic response that originates within the sympathetic nervous system, flooding the body with epinephrine? Acute pain
What kind of pain does NOT serve as a warning of tissue damage? Chronic pain
What kind of pain is initiated from the nerves and nervous system and is characterized by Tingling, burning, and shooting pain? Neuropathic pain
Define Addiction: primary, chronic, neurobiologic disease whose development is influenced by genetic, A psychosocial and environmental factors. Also referred to as Psychologic Dependence.
Define Adjuvant analgesic drugs: Drugs that are added as a second drug for combined therapy and may have additive or independent analgesic properties or both.
Define Agonist: Substance that binds to a receptor & causes a response.
Define Antagonist: Drug that binds to a receptor & prevents (blocks) a response.
Define Analgesics: Medications that relieve pain without causing loss of consciousness
Define Narcotics: a legal term applied to drugs that produce insensibility or stupor. Currently used in clinical setting to refer to any medically used controlled substance.
What term is replacing 'Narcotics' in the medical field? Opioid
Define Opioid analgesics: Synthetic drugs that bind to opiate receptors to relieve pain but are not derived from the opium plant.
Define Synergistic effects: Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater that the sum of the individual effects of the same drugs given alone. *Example 1 + 1 is greater than 2.
What are the 5 categories of non-opioid analgesics? *Salicylates *Acetic Acid derivatives *COX 2 inhibitors *Enolic Acid derivatives *Propionic Acid derivatives
What drugs fall under the 'Salicylate' category? Aspirin, Aspirin products
What drugs fall under the 'Acetic acid derivitives' category? Clinioril, Toradol
What drugs fall under the 'COX 2 inhibitors' category? Celebrex
What drugs fall under the 'Enolic Acid derivatives' category Mobic, Feldene
What drugs fall under the 'Propionic Acid derivatives' category? Ibuprofen, Naproxen
What route are non-opioid analgesics eliminated? Excreted through the liver and kidneys
How do non-opioid analgesics block pain impulses? by inhibiting the enzyme that is necessary for prostaglandin synthesis
What is the only exception to non-opioids inhibiting the prostoglandin synthesis? Tramadol (ultram)
How does Tramadol block pain? Inhibits the re-uptake of norepinephrine and serotonin.
what are the three effects non-opioid analgesics have? *analgesic effects *antipyretic effects *anti-inflammatory effects
Why would non-opioids be prescribed with opioids? increase pain control and allows for a reduced dosage of opioid medication
Define Antagonist: Drug that binds to a receptor & prevents (blocks) a response.
Define Analgesics: Medications that relieve pain without causing loss of consciousness
Define Narcotics: a legal term applied to drugs that produce insensibility or stupor. Currently used in clinical setting to refer to any medically used controlled substance.
What is associated with salicylates when administered to children and teens. Reye’s syndrome
What term is replacing 'Narcotics' in the medical field? Opioid
Define Opioid analgesics: Synthetic drugs that bind to opiate receptors to relieve pain but are not derived from the opium plant.
At what dose of acetaminophen is hepatic toxicity possible? Doses of 150mg/kg
Define Synergistic effects: Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater that the sum of the individual effects of the same drugs given alone. *Example 1 + 1 is greater than 2.
What are the 5 categories of non-opioid analgesics? *Salicylates *Acetic Acid derivatives *COX 2 inhibitors *Enolic Acid derivatives *Propionic Acid derivatives
What drugs fall under the 'Salicylate' category? Aspirin, Aspirin products
What drugs fall under the 'Acetic acid derivitives' category? Clinioril, Toradol
What drugs fall under the 'COX 2 inhibitors' category? Celebrex
What drugs fall under the 'Enolic Acid derivatives' category Mobic, Feldene
What drugs fall under the 'Propionic Acid derivatives' category? Ibuprofen, Naproxen
What route are non-opioid analgesics eliminated? Excreted through the liver and kidneys
How do non-opioid analgesics block pain impulses? by inhibiting the enzyme that is necessary for prostaglandin synthesis
What is the only exception to non-opioids inhibiting the prostoglandin synthesis? Tramadol (ultram)
How does Tramadol block pain? Inhibits the re-uptake of norepinephrine and serotonin.
what are the three effects non-opioid analgesics have? *analgesic effects *antipyretic effects *anti-inflammatory effects
Why would non-opioids be prescribed with opioids? increase pain control and allows for a reduced dosage of opioid medication
List some contra-indications of non-opioid analgesics *Known drug allergy *Bleeding disorders *Third trimester of pregnancy *Peptic Ulcer disease *Severe renal or hepatic disease
What are the 'Black box warning' contra-indications of non-opioid analgesics? *Increased risk for CV thrombotic events, MI, Stroke *Increase risk of serious GI events to include bleeding *ulceration and perforation of stomach or intestines.
What is associated with salicylates when administered to children and teens. Reye’s syndrome
What should not be used for the Tx of viral infections or fever in children & teens salicylates
True or False: A better suggested analgesic Tx of pain is combining Salicylates with NSAIDs to reduce the amount of each drug taken, thus reducing the negative side effects of each. False. Combining Salicylates with NSAIDs increases GI toxicity and provides NO therapeutic advantage
At what dose of acetaminophen is hepatic toxicity possible? Doses of 150mg/kg
What is the max standard daily dose (healthy adults) for acetaminophen? 4,000mg day
What is the toxic dose of acetominophen for the elderly or persons with liver disease? 2,000mg day
Define Antagonist: Drug that binds to a receptor & prevents (blocks) a response.
Define Analgesics: Medications that relieve pain without causing loss of consciousness
Define Narcotics: a legal term applied to drugs that produce insensibility or stupor. Currently used in clinical setting to refer to any medically used controlled substance.
What term is replacing 'Narcotics' in the medical field? Opioid
Define Opioid analgesics: Synthetic drugs that bind to opiate receptors to relieve pain but are not derived from the opium plant.
Define Synergistic effects: Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater that the sum of the individual effects of the same drugs given alone. *Example 1 + 1 is greater than 2.
What are the 5 categories of non-opioid analgesics? *Salicylates *Acetic Acid derivatives *COX 2 inhibitors *Enolic Acid derivatives *Propionic Acid derivatives
What drugs fall under the 'Salicylate' category? Aspirin, Aspirin products
What drugs fall under the 'Acetic acid derivitives' category? Clinioril, Toradol
What drugs fall under the 'COX 2 inhibitors' category? Celebrex
What drugs fall under the 'Enolic Acid derivatives' category Mobic, Feldene
What drugs fall under the 'Propionic Acid derivatives' category? Ibuprofen, Naproxen
What route are non-opioid analgesics eliminated? Excreted through the liver and kidneys
How do non-opioid analgesics block pain impulses? by inhibiting the enzyme that is necessary for prostaglandin synthesis
What is the only exception to non-opioids inhibiting the prostoglandin synthesis? Tramadol (ultram)
How does Tramadol block pain? Inhibits the re-uptake of norepinephrine and serotonin.
what are the three effects non-opioid analgesics have? *analgesic effects *antipyretic effects *anti-inflammatory effects
Why would non-opioids be prescribed with opioids? increase pain control and allows for a reduced dosage of opioid medication
List some contra-indications of non-opioid analgesics *Known drug allergy *Bleeding disorders *Third trimester of pregnancy *Peptic Ulcer disease *Severe renal or hepatic disease
What are the 'Black box warning' contra-indications of non-opioid analgesics? *Increased risk for CV thrombotic events, MI, Stroke *Increase risk of serious GI events to include bleeding *ulceration and perforation of stomach or intestines.
What is associated with salicylates when administered to children and teens. Reye’s syndrome
What should not be used for the Tx of viral infections or fever in children & teens salicylates
True or False: A better suggested analgesic Tx of pain is combining Salicylates with NSAIDs to reduce the amount of each drug taken, thus reducing the negative side effects of each. False. Combining Salicylates with NSAIDs increases GI toxicity and provides NO therapeutic advantage
At what dose of acetaminophen is hepatic toxicity possible? Doses of 150mg/kg
What is the max standard daily dose (healthy adults) for acetaminophen? 4,000mg day
What is the toxic dose of acetominophen for the elderly or persons with liver disease? 2,000mg day
What is acute hepatotoxicity treated with? acetylcysteine (mucomist)
Describe the scent of acetylcysteine (mucomist) Foul smelling (rotten eggs) with an extremely bad taste
What are some S&S of hepatoxicity? *First 24 hours: pallor, diaphoresis, malaise, vomiting *18-72 hrs: Right upper quadrant abdominal tenderness, tachycardia, hypotension *72-96 hrs: jaundice, coagulopathy, GI bleeding
What is the most common symptom of chronic Salicylate intoxication in adults? tinnitus and hearing loss
What is the most common symptom of chronic Salicylate intoxication in children? Hyperventilation and CNS effects
What are the late symptoms of Salicylate intoxication? Mixed respiratory and metabolic acidosis, respiratory failure, confusion and seizures
What are the patient teaching topics for non-opioidal analgesics *Take with a full glass of water *remain upright for 15-30 minutes after administration. *Do not take longer than 10 days Adults 5 days Children
Patients on long term therapy must inform HCP of what? non-opioid analgesic use prior to surgery (risk of bleeding)
What are the three opioid classifications *Meperidine-like drugs *Methadone-like drugs *Morphine like drugs
What medications fall under the 'methadone-like drugs' category? *Methadone *Propoxyphene/Darvon (recently removed from the market by FDA)
What medications fall under the 'morphine-like drugs' category? Morphine, Hydromorphone, Oxymorphone, Codeine, hydrocodone, oxycodone
What medications fall under the 'Meperidine-like drugs' category? Meperidine (Demerol), Fentanyl
How much of the opioid administered via PO is absorbed in the GI tract 50% absorbed from the GI tract
True or False: Opioids fall under the many drug categories that DONT cross the placenta. False. Opioids cross the placenta.
What metabolizes opiods? The liver
What excretes opioids? The kidneys
What is the result of Strong opioid analgesics (fentanyl and sufentanil) used in combination with anesthetics? Balanced anasthesia
What is the most serious adverse effect of opioid analgesics? Respiratory depression/ decrease in respiratory rate & depth
List three drugs the negatively interact with opioid analgesics *Alcohol *Antihistamines *Barbiturates *Benaodiazepines *Phenothiazines *CNS depressants
What drugs can cause increased potential for respiratory depression, seizures and hypotension MOA inhibitors
What are some contra-indications of opioids? *Increased potential for respiratory *Depression, seizures and hypotension
What medication can cause a complete or partial reversal of narcotic depression? Naloxone (narcan)
How quickly is naloxone capable of restoring respiratory function? 1-2 minutes
What medication Used in the treatment opioid dependency, blocks the euphoric effects experienced and can be used in the treatment of alcoholism? Naltrexone (ReVia)
List 4 adverse effects of Naloxone (Narcan) *hypertension *hypotension *cardiac dysrhythmias *pulmonary edema *nausea, vomiting
List 4 adverse effects of Naltrexone *nervousness *headache *withdrawal *pulmonary edema *tachycardia *nausea, vomiting.
How long after opioid medication peak should you monitor level of consciousness? 3-4 hours
True or False: Naloxones effects last as long as the opioid its blocking False. Naloxone usually lasts only 1 hour.
When pre-operative medications are given, the nurse must monitor the patient for signs of what? Respiratory depression
What reverses the effects of benzodiazapines such as Valium or Versed? Romazicon (Flumazenil)
How often should the nurse monitor the patient after pre-op opioids are given? Every 15-30 minutes until the Pt leaves for surgery
Define Anasthesia: Drugs that depress the CNS or peripheral nerves to produce diminution of consciousness, loss of responsiveness to sensory stimulation, or muscle relaxation
Define Balanced Anasthesia: use of combinations of different drug classes rather than a single drug to produce anesthesia
What is the therapeutic effect (purpose) of general anasthesia? to produce anesthesia to where the patient does not recall the surgical procedure
What is the therapeutic effect (purpose) of regional anasthesia? to produce anesthesia that results in loss of sensation to an area of the body.
Created by: Shanejqb