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Pharmacology > 25. Analgesics > Flashcards

25. Analgesics Flashcards

1
Q

Name a prototype nonopioid analgesic

A

NSAIDs and Acetaminophen

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2
Q

Name a prototype opioid analgesic

A

Morphine Sulfate

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3
Q

Name a prototype opioid agonist-antagonist

A

Nalbuphine

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4
Q

Name a prototype opioid antagonist

A

Nalaxone

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5
Q

What is the nurses role in pain?

A
  • assess pt’s pain
  • alleviate pain w/ nonpharmacologic and pharmacologic treatments
  • document pain response
  • teach pt how to manage pain
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6
Q

level of stimulus needed to create a painful sensation

A

pain threshold

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7
Q

amount of pain a pt can endure without it affecting normal functioning

A

pain tolerance

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8
Q

What should a nurse’s pain goal be for the pt?

A

pain level below tolerance level; not necessarily 0 but low enough it doesn’t affect ADLs

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9
Q

mild, moderate, or severe pain that is usually associated w/ a specific tissue injury; sudden onset and short duration

A

acute pain

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10
Q

pain with vague origin; gradual onset and prolonged duration (more than 3 months)

A

chronic pain

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11
Q

unusual sensory disturbance that often involves neural supersensitivity; often due to nervous system disease/injury; described as burning, tingling, or electric shock

A

neuropathic pain

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12
Q

Purpose of nonopioid analgesics

A
  • used for mild to moderate pain

- usually OTC

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13
Q

MOA of Acetaminophen

A
  • inhibition (weak) of prostaglandin synthesis
  • inhibition of hypothalamic heat-regulator center
  • works centrally rather than peripherally (doesn’t carry risks of NSAIDs)
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14
Q

Uses for Acetaminophen

A

decrease pain and fever

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15
Q

Adverse Reactions to Acetaminophen

A
  • elevated liver enzymes (3x upper limit of normal)
  • hepatotoxicity
  • renal failure
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16
Q

Contraindication of Acetaminophen

A

hepatic disease

17
Q

Antidote of Acetaminophen

A

acetylcysteine

18
Q

Pt teaching for Acetaminophen

A
  • teach pt to check OTC label for dosage (max dosage is 4g/day)
  • avoid alcohol ingestion w/ acetaminophen
19
Q

Normal therapeutic range of Acetaminophen

A
  • normal: 10-20 mcg/dL

- toxic: > 200 mcg/dL 4 hours after ingestion

20
Q

Purpose of opioid analgesics

A
  • used for moderate to severe pain
  • controlled substances
  • act mainly on CNS
21
Q

MOA of Morphine

A
  • depression of CNS

- depression of pain impulses by binding w/ opiate receptors in CNS

22
Q

Uses for Morphine

A

moderate to severe pain

23
Q

Adverse reactions to Morphine

A
  • hypotension
  • urticaria
  • seizures
  • ileus (slowing of peristalsis)
  • psychological dependence
  • respiratory depression
24
Q

Morphine (opioid) antagonist

A

Naloxone

25
Q

Nursing interventions for Morphine administration

A
  • monitor vital signs (hypotension and respiratory depression)
  • check for pinpoint pupils (can indicate OD)
  • have Naloxone available
26
Q

Pt teaching for Morphine

A
  • don’t drink alcohol or use other CNS depressants
  • inform patients of possible addiction
  • Pt should inform difficulty breathing, blurred vision, and headaches
27
Q

Contraindication for opioid analgesics (ex. Morphine)

A

Head injury (decreased respiration, CO2 retention, and IICP

28
Q

consists of both NSAID and opioid and used for moderate to severe pain; helps decrease drug dependency

A

combination analgesics

29
Q

What is the most common PCA medication?

A

Morphine

30
Q

Purpose of transdermal opioid analgesics

A
  • continuous pain control

- NOT for acute pain

31
Q

Most common transdermal opioid medication

A

Fentanyl

32
Q

T/F: Heat on top of a transdermal opioid patch will increase rate of absorption and may cause OD

A

True

33
Q

T/F: you should tape a transdermal patch to the pt if it is not sticking

A

False; will affect rate of absorption -> use a new patch

34
Q

4 facts about analgesic use in pt’s w/ substance use disorder

A
  • still need a complete pain assessment
  • larger doses may be needed
  • withholding meds won’t cure addiction
  • opioid agonist-antagonists may cause withdrawal
35
Q

MOA of Nalbuphine

A

inhibits pain impulses transmitted in the CNS by binding w/ opiate receptors and increasing pain threshold

36
Q

Adverse reactions to Nalbuphine

A
  • bradycardia
  • tachycardia
  • hypotension
  • hypertension
  • dyspnea
37
Q

MOA of Naloxone

A

blocks effects of narcotics by competing for receptor sites

38
Q

Uses of Naloxone

A

treats respiratory depression caused by narcotics or narcotic OD

39
Q

Adverse reactions to Naloxone

A
  • N/V
  • sweating
  • tachycardia
  • hypertension
  • Atrioventricular fibrillation (LT)
  • pulmonary edema (LT)

Pharmacology (22 decks)

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