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NRSG 106: Pharmacology > [Exam 1] Module 11 - Drug Therapy for Pain > Flashcards

[Exam 1] Module 11 - Drug Therapy for Pain Flashcards

1
Q

What are the three opoid receptors?

A

Mu, kappa, delta

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2
Q

Information about Mu receptor

A

Stimulated by opioid drugs.

They cause analgesia, or relief of pain.

Stimulation causes respiratory depression, euphoria, sedation.

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3
Q

Information about Kappa receptors.

A

Stimulated by opioid drugs.

Cause analgesia , sedation.

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4
Q

What are the for type of nonopioid analgesics that treat pain?

A

1st Gen NSAIDs (COx-1 and Cox-2 Inhibitors)

2nd Gen NSAIDs (Cox-2 Inhibitors)

Acetaminophen (Tylenol)

TRamadol (Ultram)

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5
Q

1st Gen NSAIDS: What do they do?

A

Supress inflammation, treat mild to moderate pain, reduce feveer and relieve dysmenorrhea.

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6
Q

1st Gen NSAIDS: Aspirin also inhibits

A

Platelet aggregation, making effective option for anticoagulant.

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7
Q

1st Gen NSAIDS: Often give aspirin when

A

prophylactic or long term treatment against the development of thrombi is needed

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8
Q

1st Gen NSAIDS - Prototype

A

Aspirin (ASA)

Ibuprofen (Advil and Motrin)

Naproxen (NAprosyn and Aleve)

Ketorolac

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9
Q

1st Gen NSAIDS - Expected Pharmacologic Action: NSAIDS inhibit the action of

A

Cyclooxygenase or COX. This is an enzyme that converts arachidonic acid into prostaglandins when tissue injury cocurs.

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10
Q

1st Gen NSAIDS - Expected Pharmacologic Action: Release of COX 1 enzyme stimulates

A

release of prostaglandins that work to maintain homeostasis in the body .

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11
Q

1st Gen NSAIDS - Expected Pharmacologic Action: Cox 1 acts to protect

A

gastric mucosa, enhance platelet aggregation, and promote renal function.

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12
Q

1st Gen NSAIDS - Expected Pharmacologic Action: COX -2 enzyme stimulates release of

A

prostaglandins in response to injury, which results in inflammation, pain, and fever

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13
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Gastric Mucosa of COX-1 Stimulated?

A

Gastric mucosa protected, when decrease production of stomach acid

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14
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Gastric Mucosa if COX-1 Inhibited?

A

Gastric mucosa not protected, ulcer development

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15
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Platelet Aggregation if COX-1 Stimulated?

A

Enhances platelet aggregation

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16
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Platelet Aggregation if COX-1 Suppressed?

A

Decreases platelet aggregation and anticoagulant effects- (bleeding, bruising)

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17
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to kidneys if COX-1 Stimulated?

A

Promote kdiney perfusion

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18
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to kidneys if COX-1 Inhibited?

A

Impairs renal perfusion - decreased urine output, and increased BUN and creatinine

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19
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Inflammation if COX-2 Stimulated?

A

Promotes inflammation

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20
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Inflammation if COX-2 Inhibited?

A

Decreases inflammation

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21
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Pain if COX-2 Stimulated?

A

Causes pain

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22
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Pain if COX-2 Inhibited?

A

Decreases pain

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23
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Body Temperature if COX-2 Stimulated?

A

Increases body temperature

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24
Q

1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Body Temperature if COX-2 Inhibited?

A

Decreases body temperature

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25
Q

1st Gen NSAIDS - Adverse Drug REactions: This related to the inhibition of protective effects of COX-1. This includes

A

Gastric upset, heartburn, nausea, and gastric ulceration.

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26
Q

1st Gen NSAIDS - Adverse Drug REactions: Renal dysfunction is an adverse drug reaction because

A

NSAIDs block the protective effective of COX-1 on kidneys.

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27
Q

1st Gen NSAIDS - Adverse Drug REactions: Increased risk for thromboembolic events exists when

A

clients take a non-aspirin NSAID

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28
Q

1st Gen NSAIDS - Adverse Drug REactions: Salicylism can occur, which is

A

buildup of Aspirin in the body to toxic levels.

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29
Q

1st Gen NSAIDS - Adverse Drug REactions: Reyes Syndrome, which is

A

serious disorder that has occured secondary to giving aspirin to a child who has viral infection.

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30
Q

1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Reye’s syndrome m anifests with

A

vomiting, confusion, seizures, and loss of consciousness.

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31
Q

1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Reyes Syndrome Can occur secondary to

A

metabolic conditio or when you give aspirin to an infant child who have viral infection, like influenza or chickenpox

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32
Q

1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Reyes Syndrome can cause

A

liver and brain damage and even death

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33
Q

1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Early Diagnosis and Treatment for Reye’s Syndrome includes

A

Diuretics and electrolytes to prevent swelling.

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34
Q

1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Know to avoid giving children aspirin or NSAID for

A

fever secondary to a viral infection

Acetaminophen is safe for administration

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35
Q

1st Gen NSAIDS - Interventions: Monitor for signs of

A

Bleeding, including black or dark-colored stools, abdominal pain, nausea, and hematemesis.

Bruising, Petechiae, and excessive bleeding from minor injuried.

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36
Q

1st Gen NSAIDS - Interventions: Test and Treat for

A

H. Pylori

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37
Q

1st Gen NSAIDS - Interventions: For clients at risk for gastric bleeding, what should they receieve during therapy?

A

PPI concurrently

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38
Q

1st Gen NSAIDS - Interventions: Monitor what from kidneys?

A

I/O, BUN, and Creatinine which reflect decreased kidney function

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39
Q

1st Gen NSAIDS - Interventions: To prevent REye’s Syndrome in children anda dolescents who have viral infections, use

A

acetaminophen, also called Tylenol instead of Aspirin or NSAIDs

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40
Q

1st Gen NSAIDS - Interventions: When NSAID therapy is necessary, recommend using what?

A

Non-Aspirin NSAIDs for short poeriods of time and in low doses to help minimize adverse drug reactions

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41
Q

1st Gen NSAIDS - Interventions: If provider prescribes COX-1 and COX-2 inhibiting NSAID for long-term therapy, make sure they also provide

A

low-dose aspirin toprevent embolic event

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42
Q

1st Gen NSAIDS - Administration: How do clients take this?

A

Make sure they swllow enteric-coated or sustained-release forms whole and do not crush or chew them.

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43
Q

1st Gen NSAIDS - Administration: When would discontinue aspirin before surgery?

A

Aspirin, due to their effects on platelet aggregation and bleeding

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44
Q

1st Gen NSAIDS - Administration: Epect aspirin dose to be what when giving prophylactically

A

81 mg to inhibit platelet aggregation

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45
Q

1st Gen NSAIDS - Client Instructions: Tell clients to take with

A

food, milk, or 8 oz of water to minimize GI Effects

Avoid alcohol

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46
Q

1st Gen NSAIDS - Client Instructions: CLient should report

A

persisitent gastric irritation and signs of bleeding, such as easy bruising or prolonged bleeding as well as weight changes.

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47
Q

1st Gen NSAIDS - Client Instructions: Avoid giving aspirin or NSAIDs to those under 18 who have

A

viral infection, use acetaminophen instead

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48
Q

1st Gen NSAIDS - Client Instructions: Due to risk of development of thrombi when taking non-aspirin NSAID, immediately report to provider what signs?

A

Chest pain, shortness of breath, headache, one sided numbness.

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49
Q

1st Gen NSAIDS - Client Instructions: Reinforce that the use of low-dose aspirin once daily reduces

A

risk of myocardial infarction and cererovascular accident

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50
Q

1st Gen NSAIDS - Client Instructions: First sign of Salicylism?

A

Ringing or buzzing in the ears. , along with sweating, headache, and dizziness

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51
Q

1st Gen NSAIDS - Client Instructions (Safety Alert): What is Salicylism?

A

Name for Aspirin Toxicity. Can happen with clients who take drug regularly for chronic condition such as RA.

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52
Q

1st Gen NSAIDS - Client Instructions (Safety Alert - Salicylism): Important to know what symptoms indicate that toxicity is beginning to develop such as

A

Decreased hearing and tinnitus, Headache, and Dizziness.

If drug continues to be taken, will experience N/V, Diarrhea, and Diaphoresis.

IF continued…

Fever, Confusion, Seizure, and REspiration failure can occur

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53
Q

1st Gen NSAIDS - Contraindications: Is this a Teratogenic drug?

A

Yes

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54
Q

1st Gen NSAIDS - Contraindications: What should those with peptic ulcer disease or bleeding disorder do?

A

Avoid taking thi sdug.

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55
Q

1st Gen NSAIDS - Contraindications: Non-Aspirin NSAIDs contraindication in those who have

A

hypertension

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56
Q

1st Gen NSAIDS - Interactions: What other uses increase the clients risk of bleeding?

A

Use of aspirin along with anticoagulants, glucocorticoids and alcohol

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57
Q

1st Gen NSAIDS - Interactions: What does Ibuprofen do to aspirin?

A

DEcreases anti-okatlet effects of low - dose aspirin

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58
Q

1st Gen NSAIDS - Interactions: Use of Aspirin with ACE Inhibitorsnd ARB causes

A

risk of renal failure as well as decrease anti-hypertensive effects of ACE Inhibitors

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59
Q

1st Gen NSAIDS - Interactions: 1st Gen NSAIDS - Interactions: Risk of toxicity increases with us eof what drugs?

A

Lithium Carbonate (Eskalith)

Methotrexate (Rheumatrex)

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60
Q

2nd Gen NSAIDS (Cox-2 Inhibitors): What are these?

A

Treat mild to moderate pain.

Also suppresss inflammation, reduces fever adn treat pain of dysmenorrhea

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61
Q

2nd Gen NSAIDS (Cox-2 Inhibitors): Prototype

A

Celecoxib (CElebrex)

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62
Q

2nd Gen NSAIDS (Cox-2 Inhibitors): Celecoxib is the only true

A

COX-2 Inhibitor sitll on the market.

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63
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Expected Pharmacologic Action: DEveloped in hope that drug reactions related to COx-1 would be … including

A

minimized

This includes effects on stomach, kidney, and platelets

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64
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Adverse Drug REactions: This includes

A

Gastric upset, diarrhea, heartburn, nausea, and gastric ulceration. Less of a probblem than with COX-1.

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65
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Adverse Drug REactions: What can still occur with clients who take COX-2 Inhibiting NSAID?

A

Renal dysfunction, cardiovascular, and ceebrovacular events

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66
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: Monitor for

A

Gastric Upset, heartburn, Nausea, Diarrhea and GI Bleeding

I/O, BUN, Creatinine.

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67
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: Important to treaat what prior to long-term NSAID therapy?

A

H. Pylori

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68
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: For those at risk for gastric bleeding, what else should be taken?

A

PPI Inhibitor

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69
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: What should the provider recommend to minimize drug reactions?

A

Use for short periods of time in low doses

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70
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: Monitor for signs of

A

MI and Cerebrovacular accident due to thromboembolic events

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71
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: If giving Celecoxib for long term therapy, why is aspirin recommended?

A

TO prevent those thromboembolic events

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72
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Administration: When should you give it?

A

Give 2 hours before or after Mg or Aluminum based antacids.

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73
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Client Instructions: When providing instruction for clients on long-term NSAID terapy, reinforce use o f

A

low-dose aspirin once daily to reduce risk of heart attacak adn stroke.

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74
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Client Instructions: Take this drug with

A

food, milk, or 8 oz of water and to avoid alcohol

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75
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Client Instructions: Report what to provider?

A

Persistent gastric irritation adn signs of GI Bleeding , as well as i/o, weight gain, or fluid retentionn.

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76
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Contraindications and Precautions: Is this a Teratogenic drug?

A

Yes, during third semester

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77
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Contraindications and Precautions: Contraindicated in those who have

A

severe kidney impairment, children younger than 18, clietns with GI bleeding, and allergy to celecoxib, sulfa, or sulfonamides.

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78
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Contraindications and Precautions: Use in caution for those with

A

alcohol use disorder, HF, Cardiovascular didsease, diabetees, hypertension.

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79
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: Interactis with Furosemide (Lasix) decreasing its

A

diuretic effects

80
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: Fluconzaole (Diflucan) can do what?

A

Increase celecoxib levels

81
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: THis does what to Warfarin?

A

Increases anticoagulant effects

82
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: Glucocorticoids and alcohol do what?

A

Increase risk of bleeding

83
Q

2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: ACE Inhibitors

A

Antihypertensive effects decrease

84
Q

Acetaminophen: What is this?

A

Nonopoid Analgesic to treat mild to moderate pain and reduce fever

85
Q

Acetaminophen - Prototype: Prototype?

A

Acetaminophen (Tylenol)

86
Q

Acetaminophen - Prototype: How does this compare to COX-1 and COX-2 Inhibitors?

A

Same benfits without serious adverse drug reactions

87
Q

Acetaminophen - Expected Pharmacologic Action: Acetaminophen is a

A

COX Inhibitor .. but effects limited to CNS

88
Q

Acetaminophen - Expected Pharmacologic Action: Due to lack of peripheral inhibition, it has no

A

inflammatory or anticoagulant effects . Doesnt affect gastric mucosa or platelets, decreasing risk of gastric ulcers

89
Q

Acetaminophen - Adverse Drug REactions: Limited to

A

liver damage when you give drug in toxic doses over long period of time and hypertension with daily use

90
Q

Acetaminophen - Interventions: Monitor for early signs of

A

overdose or poisoning.

This includes abdominal discomfort, N/V, sweating, and diarrhe.

91
Q

Acetaminophen - Interventions: Liver and when giving in toxic dosage?

A

Can occur in 48-72 hours

92
Q

Acetaminophen - Interventions: What to give if overdose occurs?

A

Administer Acetylcysteine, also called Mucomyst and ACetadote.

93
Q

Acetaminophen - Administration: Can give this how?

A

Orally or Rectally

94
Q

Acetaminophen - Administration: Adult dosage?

A

4 g per day.

95
Q

Acetaminophen - Administration: Toxic to liver when how much ingested?

A

4g/day.

96
Q

Acetaminophen - Administration: Be weary of cold medicine because

A

they often contain acetaminophen as well

97
Q

Acetaminophen - Client Instructions: Avoid going over how much of a dose?

A

4 gram per day.

98
Q

Acetaminophen - Client Instructions: Instruct clients to report what sign s

A

abdominal discomfort, N/V, Sweating or diarrhea

99
Q

Acetaminophen - Contraindications and Precautions: Who should not use this?

A

Those with alcoholism.

Use in caution for those with anemia, immune suppression and hepatic or renal disease.

100
Q

Acetaminophen - Interactions: Alcohol increases risk of liver injury when it interacts with

A

high doses of acetaminophen

101
Q

Acetaminophen - Interactions: Using this with warfarin increases risk of

A

bleeding

102
Q

Acetaminophen - Interactions: Cholestyramine (Questran) reduces

A

absorption of acetaminophen

103
Q

Centrally Acting Nonopioid: What is this?

A

Last group of nonopioid drugs to relieve pain . Treat moderate to moderately severe pain

104
Q

Centrally Acting Nonopioid - Prototype:

A

Tramadol (Ultram)

105
Q

Centrally Acting Nonopioid - Expected Pharmacologic Action: How doees this work?

A

Binds to selected opioid receptors and blocks reuptake of norepinephrine and serotonin in the CNS

106
Q

Centrally Acting Nonopioid - Adverse Drug REactions: Rare but when they happen, they include

A

sedation adn dizziness as well as headache, nausea, and constipation

107
Q

Centrally Acting Nonopioid - Adverse Drug REactions: Other considerations?

A

REspiratory depression rare, and seizures and urinary retention may occur

108
Q

Centrally Acting Nonopioid - Interventions: Monitor them for

A

ambulation and offer support as necessary

109
Q

Centrally Acting Nonopioid - Interventions: Dosage recommendation?

A

Lowest dose possible and for short term only

110
Q

Centrally Acting Nonopioid - Interventions: What should you give drug with?

A

Food and antiemiec as needed for nausea

111
Q

Centrally Acting Nonopioid - Interventions: What should you do if RR is below 12?

A

Stimualte breathing. Administer Opioid antagonist, such as Naloxone.

112
Q

Centrally Acting Nonopioid - Administration: Will not feel effects until

A

one hour after administration.

113
Q

Centrally Acting Nonopioid - Administration: How to take the medicine?

A

Make sure clients swallow the extended-relase form whole and do not chew or crush them

114
Q

Centrally Acting Nonopioid - Client Instructions: Avoid take drug when?

A

Prior to driving or activites that require mental alertness. Sit or lie down if feeling lightheaded.

115
Q

Centrally Acting Nonopioid - Client Instructions: To minimize risk of adverse drug reactions, encourage them to

A

take drug only when needed on a short term basis.

116
Q

Centrally Acting Nonopioid - Contraindications and Precautions: Contraindicated in clients who are

A

intoxicated with alcohol, opioids or psychotropic drugs,

Have respiratory disorders or under age of 12.

117
Q

Centrally Acting Nonopioid - Interactions: MAOIs?

A

Pose risk for a hypertensive crisis.

118
Q

Centrally Acting Nonopioid - Interactions: Use with SNRI, Tricylic Antidepressants, MAOis and TRiptans pose risk for

A

serotonin syndrome

119
Q

Centrally Acting Nonopioid - Interactions: ADministering with St Jogn wort dodes what?

A

Increases sedative effects

120
Q

Opoid Agonists bind primarily to

A

Mu-Type Opioid receptors to produce their analgesic effects

121
Q

OPioid agonist-antagonists bund to

A

mu and kappa receptors, stimulating and blocking their analgesic effects

122
Q

Opoid Agonist-Antagonists are a good alernative to opioids for clients who are

A

addicted with opioids or women in labor

123
Q

Opioid Agonists: Serve as

A

Analgesic for moderate to severe pain and may cause sedation and redce anxiety in preoperative

124
Q

Opioid Agonists - Prototype

A

Morphine

Meperidine (Demerol)

Methadone (Dolophine)

Codeine

Oxycodone (Oxycontin)

125
Q

Opioid Agonists - Expected Pharmacologic Action: Opioid agonists mimic that actions of

A

naturally occuring opioids, endophins, and enkephalins.

Do this by binding with mu receptors

126
Q

Opioid Agonists - Expected Pharmacologic Action: Stimulation of mu receptors causes

A

analgesia, sedation, euphoria, and respiratory depression

127
Q

Opioid Agonists - Adverse Drug REactions: What occurs secondary to stimulation of mu opioid receptors?

A

Respiratory depression and sedation

128
Q

Opioid Agonists - Adverse Drug REactions: Effects that accompany sedation are

A

dizziness, lightheadness and drowsiness.

129
Q

Opioid Agonists - Adverse Drug REactions: Common adverse drug reaction is

A

constipation, because they decrease intestinal motility

Along with N/V.

130
Q

Opioid Agonists - Adverse Drug REactions: Opioid agonists dilating effects on peripheral vasculature causes

A

orthostatic hypotension

131
Q

Opioid Agonists - Adverse Drug REactions: They cause what other problems?

A

Urinary retention, cough suppression, and euphoria.

132
Q

Opioid Agonists - Interventions: Closely monitor

A

VS and Pulse Oximetry, and Auscutae lungs for congestion.

133
Q

Opioid Agonists - Interventions: What to do if RR below 12?

A

Stimulate brething and administer opioid antagonist, such as Naloxone.

134
Q

Opioid Agonists - Interventions: For vomiting, give this drug with

A

food and administer an antiemetic as needed

135
Q

Opioid Agonists - Interventions: Why should you monitor I/O?

A

Watch for signs of urinary retention such as bladder distention. Encourage them to urinate every 4 hours.

136
Q

Opioid Agonists - Interventions: TO prevent dependence, make sure providere prescribes

A

the lowest possible effective dose on a short-term basis

137
Q

Opioid Agonists - Administration: What should you do before admiistration?

A

Obtain clients baseline vital signs.

138
Q

Opioid Agonists - Administration: How can you give this?

A

Orally

Intramuscularly

Intravenously

subcutaneously

Rectally

Epidurally

139
Q

Opioid Agonists - Administration: When giving over IV, how should you spread it out?

A

Give over 4-5 minutes

140
Q

Opioid Agonists - Administration: What should you be aware of for those taking it for a long time?

A

Gradual withdrawal of drugs over period of several days.

141
Q

Opioid Agonists - Client Instructions: Emphasize that they should take drug when

A

they needed it and on a short-term basis .

Don’t take prior to driving or activiies requiring mental alertness.

142
Q

Opioid Agonists - Contraindications and Precautions: Contraindicated in women who are

A

pregnant because morphone is a pregnancy risk .

143
Q

Opioid Agonists - Contraindications and Precautions: Those with what system issues are contraindicate?

A

Those with renal failure, increased intracrnaial pressure, biliary colic, or biliary surgery.

144
Q

Opioid Agonists - Interactions: They interact with what by increasing their CNS depressant effects?

A

CNS Depressants

145
Q

Opioid Agonists - Interactions: Anticholinergic Agents

A

Anticholinergic effects increase causing constipation and urinary retention.

146
Q

Opioid Agonists - Interactions: MAOIs cause

A

hyperpyrexic syndrome, which manifests as excitation, sizures, and highly elevated temperature

147
Q

Opioid Agonists - Interactions: USe with anti-hypertensives increases

A

hypotensive effects

148
Q

Opioid Agonists - Interactions: St. Johns Wort may increase

A

sedation

149
Q

Opioid Agonists-Antagonists: Help relieve

A

moderate to severe pain, and act as an adjunct to anesthesia

150
Q

Opioid Agonists-Antagonists - Prototype:

A

Butorphanol and Pentazocine (Talwin)

151
Q

Opioid Agonists-Antagonists - Prototype: Butorphanol only available as

A

injectable or nasal spray

152
Q

Opioid Agonists-Antagonists - Prototype: Pantazocine (With Naloxone) available in

A

oral form

153
Q

Opioid Agonists-Antagonists - Expected Pharmacolgic Action:: What do they do to mu and kappa receptors?

A

Mu Receptor Antagonists

Kappa Receptor Agonists

154
Q

Opioid Agonists-Antagonists - Expected Pharmacolgic Action:: These result in fewer mu-related adverse drug reactions such as

A

respiratory depression, euphoria, and dependnce

155
Q

Opioid Agonists-Antagonists - Expected Pharmacolgic Action:: They can precipitate withdrawal in clients addicted to opiids so what may clients need to reveal?

A

Opioid use before administration

156
Q

Opioid Agonists-Antagonists - Adverse Drug Reactions: Signs include

A

Limited Respiratory Depression, Sedation, Dizziness, And Lightheadedness, Drowsiness, Headache, and Nausea.

157
Q

Opioid Agonists-Antagonists - Adverse Drug Reactions: These drugs affect

A

cardiac output.

158
Q

Opioid Agonists-Antagonists - Interventions: When caring for client, ask them what before administering this drug?

A

About their opioid use

159
Q

Opioid Agonists-Antagonists - Interventions: Monitor clients when ambulating if they experience

A

dizziness or lightheadedness and consider recommending an alternative drug if nausea does not resolve

160
Q

Opioid Agonists-Antagonists - Interventions: Do not administer what to those with what medical problems?

A

Myocardial Infarction and CArdiac Insufficiency

161
Q

Opioid Agonists-Antagonists - Administration: How can you administer this?

A

Intramuscualrly, Intravenously or Intranasally

162
Q

Opioid Agonists-Antagonists - Administration: Pentazocina (Talwin) would be given orally when

A

invasive route is not warranted or clients tkane the drugs as part as home pain management

163
Q

Opioid Agonists-Antagonists - Administration: For intranasal administration of butorphanol, you give

A

one spray into one nostril and repeat every 60-90 minutes as needed

164
Q

Opioid Agonists-Antagonists - Client Instructions: Make sure clients know when to take drug?

A

Only when needed or on short-term basis

165
Q

Opioid Agonists-Antagonists - Client Instructions: Dont take drug prior to

A

driving or activites that require mental alertness.

166
Q

Opioid Agonists-Antagonists - Client Instructions: If dizziness experienced, remind them to

A

sit or lie down

167
Q

Opioid Agonists-Antagonists - Client Instructions: Instruct cliients not to take these drugs for anginal pain due to their

A

effect on cardiac output

168
Q

Opioid Agonists-Antagonists - Client Instructions: Emphaize they should not take what when taking opioid agonist antagonist

A

Opioids

169
Q

Opioid Agonists-Antagonists - Contraindications and Precautions: Who should not take this?

A

Those who have acute MI or are dependent on opioids.

170
Q

Opioid Agonists-Antagonists - Contraindications and Precautions: Take caution in clients who have

A

head i njury, increased intracranial pressure, reduced respiratory reserve or cardiac insufficiency

171
Q

Opioid Agonists-Antagonists - Interactions: Dont give this with other

A

CNS DEpressants and alcohol because it will increase CNS depression and risk of respiratory depression.

172
Q

Opioid Agonists-Antagonists - Interactions: This will decrease the effects of

A

opioids

173
Q

Opioid Antagonits: Reverse the effects of

A

opioids and treat opioid overdsose

174
Q

Opioid Antagonits: They reverse

A

the neonatal respiratory depression that can occur secondary to the mother receiving an opioid during labor

175
Q

Opioid Antagonits: Prototype

A

Naloxone (Narcan)

176
Q

Opioid Antagonits - Expected Pharmacologic Action: What are opioid antagonists?

A

An antagonist in the purest sense of the word.

Produce effects by blocking opioid receptors, effectively reversing or antagonizing effects of opioids

177
Q

Opioid Antagonits, Naloxone - Adverse Drug Reactions: Most significant reaction is

A

Ventricular Arrythmias. Can expect the HR and RR to increase.

178
Q

Opioid Antagonits, Naloxone - Adverse Drug Reactions: Abstinence Syndrome, also called withdrawal, may precipitate in clients who are

A

opioid dependent

179
Q

Opioid Antagonits, Naloxone - Adverse Drug Reactions: Symptoms that include in opioid dependent clients include

A

hypertension, vomiting, tremors

180
Q

Opioid Antagonits, Naloxone - Adverse Drug Reactions: If caring for client who overdoses on CNS depressant drug outside hospital ,you may not know if

A

client is physically dependent on opioids.

181
Q

Opioid Antagonits, Naloxone - Adverse Drug Reactions: How much to administer for someone who overdoses?

A

Several small doses with a space of time in between injections in minimize withdrawal symptoms

182
Q

Opioid Antagonits - Interventions: Closely monitor for

A

dangeous elevations in clients blood pressure.

183
Q

Opioid Antagonits - Interventions: Monitor heart rhtym for signs of clients who are opioid dependent or have

A

respiratory depression

184
Q

Opioid Antagonits - Interventions: Naloxone has no effects on drugs that are not

A

opioiods

185
Q

Opioid Antagonits - Interventions: Use in cautions for clients who have

A

cardiac irritability, a head injury with increased intracranial pressure, brain tumor, or seizure disorder

186
Q

Opioid Antagonits - Administration: You can administer this

A

Intramuscularly, Intravenously, or subcutaneously

187
Q

Opioid Antagonits - Administration: If given IV, what should you do?

A

Titrate dose carefully. Monitor vital signs every 5-15 minutes and several hours after conclusion

188
Q

Opioid Antagonits - Administration: Effects last

A

60-90 minutes , so respiratory depression can recur

189
Q

Opioid Antagonits - Administration: Naloxone might increase

A

clients pain by blocking the analgesic effect of the opoid.

190
Q

Opioid Antagonits - Administration: Prepare to admiister how?

A

Every 2-3 minutes until reversal of undesurable effect occurs

191
Q

Opioid Antagonits - Administration: Observe for

A

N/V, Tachycardia, And Diaphoresis which accompanies opioid reversal

192
Q

Opioid Antagonits - Client Instructions: When administering to someone who i sawake, inform them of

A

need for drug, possible adverse drug reactions, and return of pain

193
Q

Opioid Antagonits - Conraindications and Precautions: Those who are opioid dependent or have respiratory depression due to nonopioid drugs should

A

not take naloxone.

194
Q

Opioid Antagonits - Conraindications and Precautions: Use in caution with patients who have

A

cardiac irritability

Head injury

Increased intracranial pressure

brain tumor

Seizure disorder

195
Q

Opioid Antagonits - Interactions: Decreease effects of

A

Opioids

NRSG 106: Pharmacology (14 decks)

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