Analgesics

Question 1

Acetaminophen (Tylenol)

Answer 1

Group:Nonopiod
Antipyretic
Mechanism:Inhibition of cyclooxygenase (COX)
Indication:Analgesic, antipyretic (fever), headaches
Side Effects:occult bleeding, tinnitus, dizziness, confusion, liver dysfunction
Considerations:Overdoses are fatal (N/V, sweating), liver damage, don’t exceed dose

Question 2

Acetylsalicylic acid (Aspirin)

Answer 2

Group:Nonopiod
NSAIDs
Antipyretic
Mechanism:Inhibits production of thromboxane
Indication:Antipyretic, anti-inflammatory, antiplatelet
Side Effects:Short turn: GI bleeding, heartburn, nausea
Long term: metabolic acidosis, respiratory acidosis, dehydration, fluid and electrolyte imbalance, tinnitus
Considerations:Monitor for bleeding, give with milk/water/food, don’t give to people with GI disorders & anemia, Reye’s syndrome

Question 3

Celecoxib (Celebrex)

Answer 3

Group:Nonopiod
NSAIDs
Mechanism:Inhibits the transformation of arachidonic acid to prostaglandin
Indication:Pain, fever, arthritis, dysmenorrhea
Side Effects:Headache, eye changes, dizziness, somnolence, GI disturbances, constipation, bleeding rash
Considerations:Don’t take if allergic to sulfa, ASA, or NSAIDs, take with food, eye exam, monitor liver and renal function, avoid OTC drugs

Question 4

Ibuprofen (Advil, Motrin)

Answer 4

Group:Nonopiod
NSAID
Mechanism:Nonselective COX inhibitor
Indication:Relieve pain, reduce inflammation, fever, antiplatelet
Side Effects:GI upset (nausea, vomiting, diarrhea), skin eruption, dizziness, headache, fluid retention
Considerations:Give with milk, don’t take if allergic to sulfa, ASA, or NSAIDs, take with food, eye exam, monitor liver and renal function, avoid OTC drugs

Question 5

Naproxen (Anaprox, Naprosyn, Aleve)

Answer 5

Group: Nonopiod
NSAID
Mechanism:Inhibiting both the COX-1 and COX-2
Indication:Pain, fever, swelling, arthritis, dysmenorrhea
Side Effects:Headache, dizziness, epigastric distress
Considerations:Give with food, takes 2 weeks, don’t take if allergic to sulfa, ASA, or NSAIDs, take with food, eye exam, monitor liver and renal function, avoid OTC drugs

Question 6

Methylmorphine (Codeine)

Answer 6

Group: Opioid
Mechanism: Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication, antitussive, antidiarrheal, antihypertensive, antidepressant, sedative
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension, constipation, restlessness, excitement
Considerations:Less dependence than morphine, provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness.

Question 7

Hydrocodone & Acetaminopehn (Vicodin)

Answer 7

Group: Opioid
Mechanism: Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension, confusion
Considerations:Provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness, use extreme caution with MAO inhibitors

Question 8

Hydromorphone (Dilaudid)

Answer 8

Group:Opioid
Mechanism:Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension, urine retention
Considerations:Provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness, keep antagonist naloxone available.

Question 9

Meperidine (Demerol)

Answer 9

Group: Opioid
Mechanism: Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension, tremors, uncoordinated muscular movements, urinary retention, bradycardia
Considerations:Provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness, no renal disease, older adults increase risk of toxicity, observe for dependence, give repeated doses IM b/c irritation SQ

Question 10

Methadone (Dolophine)

Answer 10

Group: Opioid
Mechanism: Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension
Considerations:Provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness. Encourage fluids and high-bulk food.

Question 11

Morphine

Answer 11

Group: Opioid
Mechanism:Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension
Considerations:Provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness.

Question 12

Oxycodone (Percodan)

Answer 12

Group:Opioid
Mechanism:Produces analgesia, euphoria, sedation, acts on CNS receptor cells
Indication:Moderate to severe pain, chronic pain, preoperative medication
Side Effects:Dizziness, sedation, respiratory depression, cardiac arrest, hypotension
Considerations:Provide narcotic antagonist, turn, cough, and deep breathe, safety precautions, avoid alcohol, antihistamines, sedative, and OTC, avoid activities that require mental alertness.