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NUR 334: Pharmacology > Exam 1 Analgesics (new) > Flashcards

Exam 1 Analgesics (new) Flashcards

1
Q

what 4 drugs are used for pain? (opioid agonists)

A

o fentanyl
o hydromorphone
o morphine
o codeine

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2
Q

opioid indications

A

o pain
o cough (codeine only)
o diarrhea (S/E of opioids is constipation which will help with diarrhea)

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3
Q

how do opioid works? (MOA)

A

they activate opioid receptors resulting in decreased pain and decrease CNS function

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4
Q

SE/AE of opioids

A

o respiratory depression
o constipation
o nausea
o sedation

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5
Q

most common SE/AE of opioids

A

constipation

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6
Q

opioid BBW

A

o avoid alcohol and other CNS depressants
o respiratory depression
o risk for abuse and dependency

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7
Q

what opioid antagonists is used to reverse opioid overdose with signs of respiratory depression?

A

naloxone

  • restores normal breathing by blocking the effects of opioid which causes respiratory depression due to difficulty breathing (reverses resp. depression)
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8
Q

what must you assess before and after administering opioids and naloxone?

A

o assess pain and LOC
o pulse ox (oxygen)
o lung sounds
o respiratory rate
o respiratory depth

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9
Q

what to look out for regarding respiratory depression

A

o respiratory rate
o respiratory depth

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10
Q

why are opioids produced in combination medications with acetaminophen?

A

intended to lower the overall opioid used and increase relief

  • warning: risk for acetaminophen OD (too much is harmful and this combination puts people at risk)
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11
Q

example of a opioid and acetaminophen combination medication

A

Vicodin

  • hydrocodone (opioid) & acetaminophen
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12
Q

if you suspect a patient to have an addiction, can you withhold pain relief/medication?

A

no

document and discuss with provider but do not withhold

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13
Q

o pump that is controlled by pt. giving them control of pain and treatment

o gives pt. extra small doses on top of what is administered by healthcare provider

o wont be able to OD on this because pump has a lock system when it detects patient has taken an excessive amount in a short period of time

A

patient controlled analgesia (PCA)

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14
Q

what drug is used for acute cluster headache and acute migraines?

A

sumatriptan

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15
Q

what drug class is sumatriptan part of?

A

serotonin 5-HT agonist

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16
Q

what is the allotted amount of sumatriptan to avoid causing rebound headaches?

A

o should not be prescribed more than 9x/month

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17
Q

o it is first line agent for acute migraines
o teratogenic
o can cause rebound headaches if taken in excess

o can cause serotonin syndrome if taken with other serotonin medications

A

sumatriptan

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18
Q

sumatriptan is contraindicated for patients with what?

A

o cardiac disease
o uncontrolled hypertension

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19
Q

what is sumatriptan OD treated with?

A

beta-adrenergic antagonist

20
Q

NSAID

A

non-steroidal anti-inflammatory drug

21
Q

what 6 drugs are used for inflammation? (NSAID)

A

o ibuprofen
o ketorolac
o meloxicam
o naproxen
o indomethacin
o aspirin

22
Q

what enzyme results in inflammation?

A

cyclooxygenase

o cox I
o cox II

23
Q

how does NSAIDs work? (MOA)

A

inhibit (block) cox 1 & 2

o body from producing stomach protective lining
o which allows acid to break through
o inhibits prostaglandins which cause inflammation

24
Q

NSAIDs indications

A

o anti-inflammatory (RA, gout)
o analgesia
o antipyretic

25
Q

what is aspirin specifically also used for?

A

suppression of platelet aggregation
o used for prevention of cardiovascular events

(should be stopped before major surgery and childbirthc

26
Q

NSAIDs BBW

A

o GI bleeding
o cardiac events

27
Q

which NSAIDs are Rx only?

A

o meloxicam
o indomethacin
o ketorolac

28
Q

NSAIDs SE/AE

A

o GI bleeding
o nephrotoxicity (nephro = kidney)
o hepatotoxicity (hepa = liver)

29
Q

what SE/AE is caused due to aspirin only?

A

tinnitus

30
Q

aspirin should not be used in children under 18 yo due to risk of what?

A

reye’s syndrome

31
Q

what drug class only inhibits cox II?

A

NSAID - cox 2 inhibitors

32
Q

name the drug that falls under the drug class NSAID - COX 2 inhibitors?

A

celecoxib

33
Q

celecoxib indication

A

anti-inflammatory such as RA and OA

34
Q

celecoxib MOA

A

o inhibits COX2

35
Q

what does COX 1 do?

A

produces protective lining in our stomach

36
Q

what does COX 2 do?

A

responsible for inflammation

o releases prostaglandins that cause inflammation

37
Q

why is NSAID - COX 2 inhibitors not used as 1st line drug in anti-inflammatory situations?

A

high risk of adverse cardiovascular events

  • but less risk of adverse GI effects
38
Q

what drug is used for analgesia and antipyretic

o does not have anti-inflammatory properties

A

acetaminophen (tyleonol)

39
Q

what drug class does acetaminophen belong to?

A

central acting antagonist

40
Q

acetaminophen BBW

A

hepatotoxicity

41
Q

what is used to reverse acetaminophen OD

A

N-acetylcysteine

42
Q

inhibits (block) COX at the CNS level causing the same relief of pain and anti-fever as NSAIDs but do not have the same risk of GI bleeding as NSAIDs

o best for those who have kidney disease instead of NSAIDs because it is not nephrotoxic

A

central acting antagonist

o acetaminophen (tylenol)

43
Q

signs of hepatotoxicity

A

o ALT/AST
o jaundice
o liver inflammation

44
Q

what is AST/ALT?

o aspartate transaminase
o alanine transaminase

A

o enzymes

o increase levels of AST or ALT may mean some type of liver damage

45
Q

most commonly used class of drug?

A

NSAIDs

NUR 334: Pharmacology (13 decks)

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