Drugs for Pain Flashcards

Question

When is an example of morphine being used to decrease pain and air hunger?

Answer 1

for people who are on hospice to make them more comfortable through the dying process. SO THE RESPIRATORY DEPRESSION/DECREASE IN AIR HUNGER CAN BE EITHER ADVERSE OR THERAPEUTIC DEPENDING ON THE SITUATION

Answer 2

Immediate (IV)

Answer 3

2-3 hours (usually prescribed Q4H)

Answer 4

Severe Pain

Answer 5

IV (onset: 1 minute, peak: 3-5 minutes) Patch

Answer 6

oral rectal

Answer 7

Respiratory depression hypotension/orthostatic hypotension (vasodilation) n/v and constipation sedation/reduced cough reflex hallucinations/euphoria itching/flushing urinary retention

Answer 8

Respiratory depression - monitor O2 sats, RR, especially in patients with respiratory difficulties to begin with Hypotension/orthostatic hypotension - monitor BP n/v Constipation - closely monitor patients for bowel obstructions sedation/reduces cough reflex - protect airway! (aspiration), constant neuro assessment monitor for hallucinations urinary retention - assess for bladder distention every 4-6 hours, and closely monitor patients with past urinary difficulties like BPH FALL RISK

Answer 9

Avoid in pregnancy/labor (respiratory depression, dependency) avoid in patients with respiratory disorders Administer slowly (4-5 minutes, can rapidly depress breathing) - double check dose with another RN have resuscitation equipment available reversal agent - naloxone (Narcan)... opioid antagonist Administer these around the clock for cancer patients

Answer 10

naloxone (Narcan) which is an opioid antagonist - --- can cause abstinence syndrome::: will act as if they abruptly stopped taking medication and can cause withdrawal symptoms. - ---- rapid infusion - tachycardia, n/v, HTN

Answer 11

Come, respiratory depression, miosis may use narcan to reverse effects can give providers warning of possible opioid overdose,

Answer 12

YES YES YES

Answer 13

YES YES YES

Answer 14

Patient controlled analgesia, a pump at the bedside that the patient can control, can have a set basal rate that is always infusing some medication (like 1mg/hour) and on top of that the patient can push the button to dose themselves more medication

Answer 15

There is a lock-out dose for safety reasons: so over 4 hours the patient can only receive a certain amount of medication, even the frequency of dosing can have a lock out, it also helps the patient feel more safe about not overdosing themselves (huge safety mechanism to prevent overdose) PCA is a good way of allowing the patient to premedicate themselves before painful procedures When switching patient from PCA to oral doses, keep patient on at least the basal rate of PCA until the PO medication has taken effect to not interrupt pain control Make sure to tell family members that the patient is in control of their PCA not them, there has been instances where the patient is asleep and family has given patient more than they need for pain control

Answer 16

YES, usually it is used after nitrostat, but it causes dilation of the coronary arteries and reduces cardiac demand.

Answer 17

avoid other CNS depressant/alcohol avoid driving and other hazardous activities Take as directed (patients are scared of getting addicted)! dont stop abruptly and dont increase dose! Manage constipation (very common) - may need bisacodyl (Dulcolax) suppositories Manage orthostatic hypotension - get up slowly void every 4 hours and report any urinary retention cough at regular intervals (protect airway and prevent aspiration) Is using PCA, teach what was gone over in previous card.

Answer 18

combination opioid agonists IT IS IMPORTANT TO TEACH THE PATIENT ABOUT BOTH MEDICATIONS CONTAINED IN THE PILL

Answer 19

acts as antagonist on MU and agonist on KAPPA receptors

Answer 20

Low potential for abuse (low euphoria) less respiratory depression given frequently in labor (less respiratory depression)

Answer 21

less analgesic effects when compared to opioid agonists.

Answer 22

Fall risk! PCA dosing teaching caution with other CNS depressants have emergency equipment available have reversal agent available - naloxone (Narcan) Abstinence syndrome - symptoms of withdrawal if trying dependent on opioid agonists and switching to opioid agonist-antagonist (assess for opioid agonist dependence before giving), it is as if the patient abruptly stopped taking opioid agonist.

Answer 23

avoid CNS depressants/alcohol dizziness - fall risk

Answer 24

reduction of inflammation or decreasing serum uric acid levels - reduce pain, decrease in number of attacks, decrease in uric acid levels

Answer 25

decreases inflammation associated with gout

Answer 26

inhibits uric acid production

Answer 27

decreases the reabsorption of uric acid

Answer 28

take with with - causes GI distress report signs of thrombocytopenia - bleeding myopathy - muscle pain/weakness avoid with grapefruit juice

Answer 29

renal caliculi - kidney stones (drink 3L of fluid daily) avoid taking with aspirin - makes probenecid less effective and can promote episode

Answer 30

renal damage - drink 2-3L fluid daily and monitor kidneys decreases metabolism of warfarin - increases risk for bleeds! monitor PT and INR

Answer 31

vasoconstriction of intracranal blood vessels (decrease blood flow, decrease pressure, decrease HA)

Answer 32

Triptans (sumatriptan) chest pressure/coronary artery spasms/ peripheral vasoconstriction do not take within 2 weeks of MAOI (increase serotonin levels)

Answer 33

ergot alkaloids (ergostat) pregnancy category X chest pressure/coronary artery spasms/ perpipheral vasoconstriction ergots/triptants should not be taken within 24 hours of each other! (because of vasoconstrictive effects)

Drugs for Pain Flashcards

(57 cards)