Chapter 41 Non opioid analgesics Flashcards
(46 cards)
what are the the seven main principles of pain management***
-Immediate goal is to reduce pain so that a person can perform ADLS
-patient should be considered expert in their own pain
-pain management is a patients right
-Non pharmacological interventions should be encouraged because of less adverse effects
-combo therapy is best (opioid non opioid) since it reduces adverse effects
-dosing should be individualized
-adverse effects should be anticipated and prevented
what is a useful way to create an objective rating for pain***
use a pain scale ie pain on a scale of 1-10
why is around the clock dosing important for pain management
because it is easier to maintain pain free level than eliminate escalating pain
what are the 5 common truths about pain***
-Patients who are in pain may not appear to be in pain
-Patients can sleep when their in pain
-Very few patients become addicted to their medication (0.01%)
-patients who are addicted to medication do not necessarily over report pain because they are drug seeking
-Vital signs are not a reliable indicator of pain
What is the definition of analgesia
absence of sensibility to pain
what is another indication of tricyclic antidepressants besides depression***
used for neuropathic pain
at what stage of the analgesic ladder can tricyclic antidepressants be used
they can be used at all three steps of the analgesic ladder
how do antidepressants work as an adjuvant drug
they block the reuptake of serotonin and norepinephrine to block the transmission of pain
what are the three things that Non Opioid analgesics are characterized by ***
- they have a ceiling effect
- They do not produce tolerance or physical dependance
- many are available without a prescription
what are the two categories of Non opioid analgesics
NSAIDS
Acetaminophen
What are the three major classes of NSAIDS
- Salicylates
- Ibuprofen/COX-1 inhibitors
- Cyclooxygenase COX 2 inhibitors
What medication is used to treat or prevent a MI***
ASA not Ibuprofen
What are NSAIDS used for***
- Anti inflammatory
- Analgesic
- Antipyretic
why does inflammation occur in the body***
upon injury cells release numerous chemicals into extracellular space (think the soup) which increases permeability of blood vessels which causes the edema
What do ASA and ibuprofen inhibit to prevent pain***
they inhibit cyclooxygenase COX synthesis
what is the max dose of ibuprofen in one day
3,200 mg/day as long as the person is over 70 kg
What does ASA stand for
Acetylsalicylic Acid
what is the brand name of ASA
aspirin
what COX does Aspirin block
ASA blocks both COX-1 and COX-2
what COX does ibuprofen block
Ibuprofen blocks both COX-1 and COX-2
what is the max dose of aspirin per day
max dose is 4 g per day
how does ASA produce an antiinflammatory effect and what is an adverse effect of this***
ASA block the production of prostaglandins however as it is absorbed through the stomach it causes cellular damage and it also reduces the amount of protective mucus in the stomach
what are three conditions where the antiplatelet effects of ASA are helpful
TIAs
Unstable angina
MI
is ASA more effective in women or men***
more effective in males than females
