Medications Flashcards
(36 cards)
4 main categories of medication
- Analgesics
- Sedatives + Paralytics
- Vasopressors and inotropes
- Anticoagulants
3 sources of sub-optimal pain management
- inadequate
- Excessive
- not on schedule
Effect of sup-optimal pain management
- Delayed mobilization
- inability to wean from ventilator
- Poor respiratory state
- +/- use of reversal drugs
- Delirium
Leading to prolonged stay in ICU
4 ways to optimize analgesia
- Follow an interdisceplinary, structured approach to analgesia
- Use a patient-specific validated pain scale
- address underlying source of pain
- Minimiza and be aware of adverse effects
Facial signs of underlying pain
- Brow lower
- Lid tighten
- Eye closure
- Cheek raise
- nose wrinkle
Facial signs of transient pain
- Brow lower
- Lid tighten
- Eye closure
- Cheek raise
- nose wrinkle
- lip raise
- mouth open
Jaw drop
3 pain assessment tools
- Behavioral pain scale
- Critical care pain observation tool
- Wong-Baker FACES pain rating scale
What is the difference between analgesia and anesthetic
Analgesia - pain relief
Anesthetic - blocking sensation including pain
What are types of analgesia
Opiates
NSAIDS
What are types are anesthetic
General anesthetic
Nerve blocks
Numbing agents
What are 3 levels of the nervous system analgesias can effect
- CNS (brain)
- Spinal level
- Peripheral nerve root
At what level does acetaminophen work?
CNS (brain)
At what level do NSAIDS work
Peripheral nerve root
At what level do opioids work
- CNS (brain)
- Spinal level
How do opioids work
- bind to opioid receptors (brain, spinal cord, other organs) and block pain signals sent from brain to the body and release large amounts of dopamine
3 non-opioid drugs used in ICU
- Acetaminophen
- NSAIDS
- Gabepentic or pregabalin
Whic of the non-opioid drugs used in ICU is the quickest acting? Which lasts the longer?
Acetaminophen and NSAIDS both 30mins to 1hour
Gabapentin and pregabalin
Precautions with acetaminophen
Caution with liver failure/alcoholism
Precautions with NSAIDS
Long term use can increase GI/renal/bleeding complications
Precautions with Gabapentin or pregabalin
- Can sedate
- Monitoring with renal dysfunction
Which non-opioid drugs used in ICU is used for neuropathic pain
Gabapentin or pregabalin
Opioids supress drive to ___
breath
3 opioids used in ICU
Morphine
Hydromorphone
Fentanyl
Which of the 3 opioids used in ICU is the strongest?
Fentanyl 100x stronger than morphine (hydromorphone 10x stronger than morphine
