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PHTH 564 - ICU > Meds > Flashcards

Flashcards in Meds Deck (67)
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1

4 types of meds we need to be aware of ?

1. analgesics
2. sedatives and paralytics
3. vasopressors and inotropes
4. anticoagulants

2

To optimize analgesia, use what kind of pain scale?

patient-specific validated pain scale

3

Infusion goals should be reassessed every __ hours; reduce by ___% if sedation goals are met

6;25

4

Goal in the ICU is to keep pt's pain intensity rating NRS < __ or BPS < __

4;6

5

BPS scores range from __ (no pain) to __ (max pain)

3;12

6

What are the 3 categories in the BPS?

1. facial expression
2. upper limb movements
3. compliance with mechanical ventilation

7

The critical-care pain observation tool ranges from _-_

0-8

8

_____ = pain relief; includes opiates, NSAIDS, other oral meds

analgesia

9

______ = blocking sensation, including pain; includes general anesthetic, nerve blocks, numbing agents

anesthetic

10

____ _____ analgesia uses multiple types of analgesia, and works on different levels of the NS

multi-modal

11

_____ blocks pain signals sent from brain to the body and release large amounts of dopamine

opioids

12

3 non-opioid drugs used in the ICU?

1. acetaminophen
2. NSAIDS
3. gabapentin or pregabalin

13

Issues with acetaminophen?

caution with liver failure / alcoholism

14

Issues with NSAIDS?

long term use can increase GI / renal bleeding complications

15

Take note of what with gabapentin or pregabalin?

- for neuropathic pain
- can sedate
- monitor renal dysfunction

16

3 opioid drugs used in ICU?

1. morphine
2. hydromorphone
3. fentanyl

17

Issues with morphine ?

drug accumulates in renal failure, itchy skin

18

Take note of what with hydromoroph / dilaudid?

- 5 x as strong as morphine
- preferred in elderly and renal dyfunction

19

Take note of what with fentanyl?

- quick onset
- good for procedural pain
- 100x as strong as morphine

20

Opioid side effects in CNS?

decreased LOC, delirium

21

Opioid side effects in resp?

depression (decreased drive to breathe, decreased RR)

22

Opioid side effects in CVS?

decrease BP/MAP/HR

23

Opioid side effects in gut?

decreased motility, nausea

24

Opioid side effects derm?

rashes

25

3 common anti-emetics?

1. dimenhydrinate (gravol)
2. ondansetron
3. dexamethasone

26

4 PT implications with analgesics?

1. consider timing of analgesia with active treatment for optimal pain control
2. look for trends in analgesia needs with care / movement
3. be alert for resp side effects
4. be aware of how our interventions can increase or prevent pain, and consider what we can offer for pain control

27

Always address ______ sources for sedation

underlying

28

3 types of sedation ?

1. Light IV sedation
2. Daily sedation interruption
3. Deep IV sedation

29

Current best practice is to _____ sedation

minimize (least amount to reach goal)

30

3 common sedatives?

1. benzodiazepines
2. propofol
3. dexmedetomidine (Precedex)