Ch. 26 - Nonopioid & Opioid Analgesics Flashcards Preview

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Flashcards in Ch. 26 - Nonopioid & Opioid Analgesics Deck (67)
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1

Pain:

Stimulus applied to body = electrical impulses are initiated in the CNS

Impulses perceived in 2 ways (2 DIFFERENT things):
1.) Pain threshold
2.) Pain tolerance

2

Pain Threshold:

Level of stimulus results in perception of (how body) pain:
1.) Physiological
2.) About same for everyone

3

Pain Tolerance (1):

Amount of pain an indiv can withstand:
-Without disrupting normal functions
-Without needing analgesic tx

4

Pain Tolerance (2):

Varies by: 
1.) Client’s environment
2.) Culture
3.) personality, etc.

5

Gate Theory (1):

Pain sensations travel along a sensory nerve pathways (like a highway driving back and forth) to brain

-limited # of sensations can travel at one time

6

Gate Theory (2):

Certain cells regulate flow of impulses:
-Stops impulses from reaching brain

7

Gate Theory (3):

Learned response to pain:
= open the gate’ or ‘close the gate’
1.)To allow pain sensations to travel to the brain
2.) Emotions
3.) Distraction techniques (close the gate)

8

Ascertain Severity of Pain:

CRIES Scale:
-Crying
-Requires Ox (O2)
-Increased vital signs
-Expression
-Sleeplessness

9

Types of Pain (1):

Acute:
-Occurs suddenly
-Responds to tx
*Mild – moderate - severe

10

Types of Pain (2):

Chronic:
-Lasts > 6 months
-Difficult to tx or control

11

Undertreatment of Pain:

Undesirable Effects:
1.) Increased heart rate, resp rate, BP
2.) Increased stress response
3.) Lack of moving/ambulating

12

Analgesics:

Drugs that relieve pain without causing loss of consciousness

13

Nonopioid Analgesics:

1.) Less potent than opoid analgesics
2.) Tx: mild – moderate pain
3.) Usually over-the-counter- (OTC)

14

NSAIDs:

1.) ASA
2.)ibuprofen (Motrin, Advil)
3.) naproxen (Aleve)

15

NSAIDs – Action / Effect:

1.) Analgesic
2.) Antipyretic
3.) Antiinflammatory

-Inhibit synthesis of prostaglandin(released with inflammation & causes pain)

-Decreases platelet aggregation (clotting) -- ASA

16

NSAIDs Side Effects/Adverse Reactions:

1.) Gastric irritation
2.) Hypersensitivity ( tinnitis)

17

acetaminophen (Tylenol) (1):

Analgesic
Antipyretic
No antimflammatory effect
Does not
-STRICTLY FOR PAIN & FEVER

18

acetaminophen (Tylenol) (2)

-Many products contain acetaminophen!
*Safe for children
-Po, rectal
-Dosage:
* 325(1 tablet)-650 mg every 4-6h PRN
-Based on age (for children)

19

acetaminophen (Tylenol) (3):

Overdose (OD) = hepatotoxicity 
-deal d/t hepatic necrosis

*If OD suspected 
-Call poison control center IMMEDIATELY

20

Other Nonopioid Analgesics:

-tramadol (Ultram)
*Mod – severe pain
Contraindicated --> Severe alcoholism, with use of opoids:
- n/v
- dizzy
-HA
-seizures

21

Opioid Analgesics (1):

“We’re not in Kansas anymore!”
- (opium comes from “Poppy Seads”)

22

Opioid Analgesics (2):

-Most potent analgesic
-Binds onto opioid receptors in CNS
*Inhibits transmission of pain impulses
*Alters perception of pain

23

Opioid Analgesics (3):

Variation in potency depends on affinity for opioid receptors
*Better fit* = *greater analgesic response*

24

Opioid Analgesics (4):

Mod – severe pain from visceral (organs/GI system) sources
1.) Cough suppressant
2.) Suppresses GI motility (can be used to treat diarrehea)
3.) All types= dependence
*Controlled substance

25

**Adverse Effects** (opiod):

1.) **Respiratory depression = most serious**
-Monitor closely: NOT to p/t with head injuries

2.)Tolerance & dependence:
-Abstinence syndrome = withdrawal symptoms
-Pruritis

26

Morphine Sulfate:

Prototype drug:
-ALL OTHER OPIODS are measured in comparison to MORPHINE:

27

Morphine Sulfate cont...

1.) Strong opioid analgesic
2.) Good for acute pain
-Myocardial infarction
-Cancer
-Drug of choice for mod-severe pain in children
3.) Po, SQ, IM, IV

28

Nursing Process:

Acute pain r/t surgical tissue injury:
-AEB(as evidence by): subjective data

*Risk for ineffective breathing patterns r/t excess morphine dosage

29

Nursing Interventions:

1.) Adm before pain is too severe
2.) Monitor VS (vital signs)
-Resp

30

Nursing Interventions cont...

4.) Check bowel sounds
5.) Check pupil changes (very small = sign of overdose) & reaction
6.) Have naloxone ( Narca = life saver) avalible  used for respiratory depression