DRUG REVIEW Flashcards
(25 cards)
Opioid Analgesics
Morphine Demerol (meperidine) Tylenol #3 (codeine) Narcan (naloxone hydrochloride) Vicodin (hydrocodone & acetaminophen)
Attach to a receptor in the Central Nervous System
Morphine
Schedule 2 drug
-Opioid Receptor Agonist
-Binds to Mu and Kappa receptors
-Watch for severe respiratory depression
Overdose of morphine is treated with Narcan (naloxone)
Demerol (meperidine)
Schedule 2 drug
-Opioid Agonist
-Use causing w/ alcoholism and renal or hepatic impairment
Interacts w/ other sedatives
Narcan (naloxone)
Opioid Antagonist
-Reversal of CNS depression and respiratory depression because of Opioid overdose
Used in Morphine OD
Vicodin
Opioid agonist / non opioid analgesic combination
Acetaminophen (Tylenol)
Prototype non-opioid Analgesic
Non-Opioid Analgesic
- Mildly inhibits prostaglandins
- Overdoses are lethal
- NO ANTI-INFLAMMATORY PROPERTIES
Risk of liver failure is significantly higher in pt’s who CONSUME ALCOHOL
Not to exceed 4g/day Use acetylcysteine (Mucomyst) in event of OD
Celebrex (celecoxib)
COX-2 inhibitor (Prototype)
-relieves pain, fever, and inflammation
Classes of Non-Opioid Pain Drugs
- Acetaminophen
- NSAID’s
- Salicylate’s
- Selective Cox-2 inhibitors
Aspirin (ASA)
-Prototype Salicylate
Anticoagulant, antipyretic, anti-inflammatory, and analgesic
-may cause distress and bleeding
-May increase action of oral hypoglycemic agents
Acts on BOTH COX-1 and COX-2
Stop taking aspirin 1 week before an elective surgery
Advil (ibuprofen)
-NSAID prototype
inhibit COX and prevent formation of prostaglandins
-used for moderate pain and anti-inflammation
GI upset, acute renal failure
Imitrex (sumatripan)
-Antimigraine prototype (Tripan)
constricts certain intracranial vessels
- helps abort migraines (PROPHYLACTIC)
- ADVERSE EFFECTS: GI upset, INCREASE BP
Ergostat (Ergotamine tartrate)
-Prototype Ergot Alkaloid
Promotes Vasoconstriction
-Terminate ONGOING MIGRAINE
Adverse effects:
- GI upset
- Numbness and tingling in fingers and toes
- Angina-like pain
- Tachycardia
NSAID’s
1st Generation (Cox-1 & Cox-2 inhibitors):
- Aspirin
- Ibuprofen (Motrin, Advil)
2nd Generation (selective Cox-2 inhibitor) -Celecoxib (Celebrex)
Inhibition of COX-1
Can result in decreased platelet aggregation and kidney damage
Inhibition of COX-2
Results in decreased inflammation, fever, and pain
NSAID Therapeutic Uses
Analgesia for mild to moderate pain such as:
- Osteoarthritis
- Rheumatoid arthritis
Fever reduction
Inhibition of platelet aggregation protecting against stroke and MI (Aspirin)
NSAID Side effects
- May lead to GI bleeding and perforation
- Renal dysfunction
- decreased urine output, increased BUN and creatinine levels - Salicylism (Aspirin)
- S/S include tinnitus, sweating, headache, and dizziness - Reye syndrome (Aspirin)
- When aspirin is used in children
1st Generation NSAIDS
-Contraindications
- Pregnancy risk category D
- Peptic ulcer or bleeding disorders
Use caution in:
- Older adults
- Clients who smoke or have history of alcoholism
- clients w/ H. pylori infection
- Asthma
2nd Generation NSAID’s
-Contraindications
- Celebrex is contraindicated in clients with allergy to Sulfonamides
- Use caution in clients who have cardiovascular disease
Opioid Side Effects
- Respiratory depression
- Stop opioids if RR is <12/min - Constipation
- Orthostatic hypotension
- Urinary Retention
- Cough suppression
- Sedation
Meperidine
-Contraindication
Contraindicated for clients w/ renal failure because of the accumulation of normeperidine, which can results in SEIZURES & NEUROTOXICITY
Migraine medication
- Ergotamine (Ergostat)
- sumatriptan (Imitrex)
Migraine meds prevent the inflammation and dilation of the intracranial blood vessels. (CONSTRICTING VESSELS)
- stopping an acute migraine attack
- prevention of migraine attack
sumatriptan (Imitrex)
-Side Effects/ contraindications
- Chest pressure
- Coronary Artery Vasospasm/ Angina
-Do not administer to a client who has or is at risk for CAD - Dizzienss or vertigo
___
Contraindicated in clients w/: - Liver failure
- Ischemic Heart disease
- History of MI
- Uncontrolled HYPERTENSION
- other heart diseases
ergotamine (Ergostat)
-Side effects / Contraindications
- GI discomfort
- Physical dependence
- Fetal abortion
____
Contraindicated in - renal &/or liver dysfunction
- Sepsis
- CAD
- Pregnancy Category X