DRUGS AND HOW THEY WORK

Question 1

opioids action

Answer 1

-blocking receptors in the CNS, when those receptors are blocked, the perception of pain is blocked

-Bind to receptors in the spinal cord, thus blocking the release of neurotransmitters involved in pain transmission.
Suppress the Central Nervous System

Question 2

opioids rationales for use

Answer 2

Used for the treatment of moderate to severe pain.

Question 3

opioids prototype

Answer 3

morphine –
meperidine(Demerol)
codeine
hydromorphone(Dilaudid) –
fentanyl(Duragesic)
oxycodone(+ acetaminophen = Percocet)
Hydrocodone(+acetaminophen= Vicodin)

Question 4

opioids therapeutic effects

Answer 4

alleviate moderate to severe pain, reduce cough, relieve diarrhea and induce anesthesia

Question 5

opioids adverse effects

Answer 5

CNS depression
◦Respiratory depression
◦Disorientation
◦Sedation
Constipation
Nausea and vomiting
Pruritis (itching)
Urinary retention

Question 6

opioids assessments before giving

Answer 6

Allergies
Alcohol use
Pain level
Level of consciousness
Vital signs

Question 7

opioids teaching

Answer 7

For patients on long term opioids, instruct on ways to counteract the side effects of constipation

Question 8

opioids successful outcomes

Answer 8

Patient will report decreased or no pain

Question 9

acetaminophen action

Answer 9

causes pain impulses to be blocked peripherally, in response to the inhibition of prostaglandin synthesis.

Question 10

acetaminophen rationales for use

Answer 10

To lower temperature (fever) and to relieve mild to moderate pain

Question 11

acetaminophen prototype

Answer 11

abenol ,acephen, APAP, aspirin free anionic, cetafen, feverall, infantaire, little fevers, mapap, nortemp children, ofirmev, pain eze, silapap, silapap, silapap infants, tylenol, valorin

Question 12

acetaminophen therapeutic effects

Answer 12

analgesia, antipyresis

Question 13

acetaminophen adverse effects

Answer 13

Liver toxicity with an over dosage or frequent ingestion of large amounts over time

• rash
• nausea
• vomiting
• blood disorders or dycrasias (anemias)
• hepatotoxicity and nephrotoxicities

Question 14

acetaminophen assessment before giving

Answer 14

• overall health status
• alcohol usage
• self-medication: amt, frequency and type of drugs taken (esp with OTC drugs)
• assess type, location and intensity of pain
• assess fever, not signs of: diaphoresis, tachycardia, and malaise
• elvatuate hapatic, hematologic and renal function

Question 15

acetaminophen teaching

Answer 15

• Don’t take with alcohol

- Follow the package dosaging instructions

Question 16

acetaminophen successful outcomes

Answer 16

• relief to mild to moderate pain

- reduction of fever

Question 17

aspirin action

Answer 17

Inhibit the synthesis of prostaglandins

Question 18

aspirin rationales for use

Answer 18

for the treatment of mild to moderate pain, fever, or inflammation; also as prevention for strokes and heart attacks

Question 19

aspirin prototype

Answer 19

ascriptin, aspercin, aspergum, aspirtab, bayer aspirin, bufferin, easprin, ecotrin, genacote, halfprin, healthprin, ZORprin

Question 20

aspirin therapeutic effects

Answer 20

analgesia. reduction in inflammation. reduction of fever.prevention for strokes and heart attacks
- antipyretic
- non-opioid analgesics

Question 21

aspirin adverse effects

Answer 21

• bleeding tendencies
• gastrointestinal irritation
• Renal side effects

Question 22

aspirin assessment before giving

Answer 22

• check for allergies
• assess for pain
• monitor hepatic function

Question 23

aspirin teaching

Answer 23

• Instruct patients to take aspirin with milk or food.
• Stress importance of following the prescription label instructions
• Monitor for GI symptoms or signs of bleeding
• No aspirin for children under the age of 18 due to the risk of Reye’s syndrome

Question 24

aspirin successful outcomes

Answer 24

• relief of mild to moderate discomfort
• increased ease of joint movement
• reduction of fever
• prevention of transient ischemic attacks
• prevention of MI

Question 25

muscle relaxants action

Answer 25

reduction of muscle spasm

Question 26

muscle relaxants rationale for use

Answer 26

relief of painful musculoskeletal conditions such as muscle spasm

Question 27

muscle relaxants prototype

Answer 27

``` baclofen (lioresal) cyclobenzaprine (flexeril) carisoprodol (soma) chlorzoxazone (paraflex) metaxalone (skelaxin) methocarbamol (robaxin) tizanidine (zanaflex) ```

Question 28

muscle relaxants therapeutic effects

Answer 28

skeletal muscle relaxants( centrally acting)

Question 29

muscle relaxants adverse effects

Answer 29

euphoria, lightheadedness, dizziness, drowsiness, fatigue, confusion, and muscle weakness less common: GI upset, headache, slurred speech, muscle stiffness, constipation, sexual difficulties in males, hypotension, tachycardia and weight gain

Question 30

muscle relaxants assessment before giving

Answer 30

- complaints of insomnia - time it takes to fall asleep and energy level when they wake up - difficulties sleeping - vital sign (BP)- both supine and standing measurements - pulse rate and rhythm - presence of pain - head to toe assessment - use of alcohol - smoking history - past and current use of meds - changes in health status - level of orientation - mood changes - depression or other mental disorders

Question 31

muscle relaxants teaching

Answer 31

- keep drugs out of reach from children - always check with the prescriber or pharmacists before taking any over-the-counter medication - take med as prescribed - avoid driving or any activity that involves mental alertness - do not abruptly discontinue or withdraw these medication - hangover effects may occur - avoid smoking in bed or when lounging - teach about drug/drug and drug/food interaction - effect of grapefruit or grapefruit juice on benzodiazepines

Question 32

muscle relaxants successful outcomes

Answer 32

- decrease spasticity - reduction of choreiform movements in Huntington's chorea - decrease rigidity in parkinsonian syndrome - relief of pain from trigeminal neuralgia

Question 33

NSAIDS action

Answer 33

* Block formation of prostaglandins * Suppress the hypothalamus * Reduce platelet aggregation and tissue permeability * All leading to their anti-inflammatory, analgesic and antipyretic effects

Question 34

NSAIDS rationales for use

Answer 34

have analgesic, anti-inflammatory, and antipyretic (anti-fever) activity, used for mild to moderate pain, headaches , fever and inflammatory disorders like arthritis

Question 35

NSAIDS prototype

Answer 35

- ibuprofen (Motrin) - naproxen (Naprosyn) - ketorolac(Toradol) -Only NSAID that can be given parenterally - Cox –2 inhibitors: - celecoxib(Celebrex

Question 36

NSAIDS therapeutic effects

Answer 36

Mild to moderate pain, headaches Fever Inflammatory disorders like arthritis (rheumatoid, juvenile and osteoarthritis, ankylosing spondylitis) treatment of gout and hyperuricemia

Question 37

NSAIDS adverse effects

Answer 37

- bleeding tendencies - gastrointestinal irritation - Renal side effects

Question 38

NSAIDS assessments before giving

Answer 38

perform a head-to-assessment measure vitals take med history check lab results reflecting hematologic, renal and hepatic functioning

Question 39

NSAIDS teaching

Answer 39

Instruct patients to take these medications with milk or food. Assess for GI complaints and for bleeding symptoms. Don’t takewith aspirin Tell physician that they are taking this type of medication. Follow the label instructions and don’t exceed the daily dosage

Question 40

NSAIDS successful outcomes

Answer 40

decrease in acute pain, decrease in swelling, pain, stiffness, and tenderness of joint or muscle area; improved ability to perform ADLs; improve muscle grip and strength, reduction in fever; return to normal lavatory values for CBC and sedimentation rate; and return to a less inflamed state as evidenced by improved sedimentation rates, radiographic examination, computed tomographic scan or magnetic resonance imaging.