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midterm 2 Flashcards

1
Q

whos more effected by depression

A

women

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2
Q

different kinds of antidepressants

A

selective serotonin reuptake inhibitors

selective antagonist receptor inhibitors

serotonin & norepinephrine reuptake inhibitors

norepinephrine dopamine reuptake inhibitor

tricyclic

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3
Q

ex of SSRI

A

citlaopram, fluoxetine, sertraline, paroxetine, fluvoxamine

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4
Q

SARI ex

A

trazadone

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5
Q

SNRI ex

A

venlafaxine

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6
Q

NDRI

A

bupropion

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7
Q

TCA ex

A

amitriptyline, clomipramine

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8
Q

MAOI ex

A

phenelzine, tranylcypromine

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9
Q

is there an increased risk of suicide when a pt starts taking antidepressant

A

YES (increase mood & anxiety may feel more suicidal or may want to act more on feelings)

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10
Q

how long does it take for effects to start being felt with antidepressants

A

2 weeks, 6 weeks for full therapeutic effect

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11
Q

off label uses of antidepressants

A

smoking cessation, insomnia, fibromyalgia, pain

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12
Q

depression due to an imbalance of

A

monoamine neurotransmitters

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13
Q

what are the monoamine neurotransmitters

A

serotonin, norepinephrine, dopamine

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14
Q

serotonin deficiency causes

A

disruptions in regulating mood, obsessions, anxiety, panic, sexual response, appetite, sleep, memory, learning

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15
Q

norepinephrine works on

A

mobilization of body & brain for action

ANS

fight or flight

mood, attention, concentration, working memory, speed of processing information

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16
Q

dopamine role is

A

motivating behaviour

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17
Q

MAOI is

A

oldest med

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18
Q

MAOI inhibits

A

MAO enzyme

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19
Q

MAO enzyme usually…

A

breaks down serotonin, norepinephrine, dopamine

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20
Q

when MAO is deactivated, there is

A

increase in serotonin, norepinephrine

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21
Q

why is MAOI not first choice of treatment

A

bad side effects

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22
Q

many side effects from MAOI occur becayse

A

interactions with norepinephrine & serotonin & CNS stimulation

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23
Q

common side effects of MAOI

A
  1. ortho hypotension = effect on norepinephrine
  2. anticholinergic effects (dry effects = dry mouth, retention)
  3. anxiety, agitation, restlessness = CNS stimulation
  4. insomnia
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24
Q

can OD on MAOI be fatal?

A

YES

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25
Q

can MAOI be taken with other antidepressants? why?

A

NO & serotonin syndrome

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26
Q

with MAOI, you need to . . . before new med started

A

2 week wash out period

MAOI + new antidepressant = too much serotonin = serotonin syndrome

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27
Q

before starting MAOI you need to

A

do a 1 week wash out period

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28
Q

what is the exception with with MAOI & wash out periods

A

fluoxetine = 5 to 8 week wash out period!!!!

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29
Q

MAOI need to avoid

A

foods tyramine

(aged, fermented, pickled, smoked)

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30
Q

why do certain foods need to be avoided with MAOI

A

hypertensive crisis

liver can’t metabolize dietary tyramine –> moves into circulatory system == release of epinephrine = hypertensive crisis & risk for stroke

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31
Q

examples of foods to be avoided with MAOI

A

preserved meats

aged cheeses

fermented (beer, ale, soy sauce)

pickled herring

caffeine

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32
Q

hypertensive crisis symptoms

A

palpitations, increased HR, tight chest, stiff neck, throbbing/radiating headache, high BP, can be fatal

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33
Q

tricyclic inhibts

A

reutake of serotonin & norepinephrine = increasing amount of serotonin

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34
Q

TCA work in

A

synapse & inihibit reabsorption therefore increasing volume

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34
Q

CNS effects of TCA

A

works on norepinephrine

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34
Q

side effects TCA

A

tachycardia, dysrhythmias, ortho hypotension

CNS effects (sedation, nightmares, anixety)

weight gain

anticholinergic

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34
Q

TCA treat

A

depression, anxiety, OCD, insomnia, pain (chronic)

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34
Q

can TCA OD be fatal

A

highly lethal

less than week supply needed

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35
Q

1st choice treatment for depression

A

SSRI

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36
Q

SSRI block

A

reuptake of serotonin

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37
Q

SSRI treat

A

MDD, GAD, social anxiety, OCD, PTSD, panic

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38
Q

side effects of SSRI

A

GI complaints, headache, dizziness, anxiety, akathisia, insomnia/sedation, sexual dysfunction

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39
Q

since SSRI don’t block norepinephrine, there is

A

less cardiac effects

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40
Q

SARI used for

A

sleeping

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41
Q

SNRI watch for

A

BP

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42
Q

NDRI 2 cateogires

A

wellbutrin (depression) = CNS stimulation

zyban (smoking cessation)

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43
Q

discontinuation syndrome effects

A
  • flu symptoms (malaise, headache, GI upset, dizziness)
  • mood disturbances
  • aggression
  • suicidal tendencies
  • sleep disturbances
  • electric shock sensations
  • vivid dreams
  • impaired concentration
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44
Q

how fast can discontinuation syndrome occur

A

1-3 days after stopping (depending on 1/2 life)

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45
Q

how to properly discontinue antidepressants

A

taper

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46
Q

do you need to avoid drug holidays with antidepressants?

A

YES because discontinuation syndrome

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47
Q

can discontinuation syndrome occur if antidepressants nottaken regularly

A

YES

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48
Q

serotonin syndrome is the

A

reaction to excess serotonin

happens when combo of agents given at same time w/o sufficient wash out period

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49
Q

serotonin syndrome can be fatal?

A

YES

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50
Q

symptoms of serotonin syndrome

A

sudden onset, fever (moderate), diaphoresis, muscle rigidity, hyperreflexia, increased HR & BP, delirium, hyperarousal, agitation

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51
Q

difference b/w serotonin syndrome & NMS

A

serotonin = sudden onset, mild fever, excess serotonin

NMS = gradual onset, increased CPK

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52
Q

NMS is the reaction to

A

dopamine

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53
Q

NMS symptoms

A

gradual onset

extreme stiffness/muscle rigidity, hyporeflexia, pupils normal, elevated CPK, fever, increased HR & BP, diaphoresis, changes in LOC

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54
Q

when switching meds…

A

do not abruptly stop med but taper off gradually increasing dose of different med

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55
Q

treatment options for depression

A

CBT, psychotherapy, ECT, transcranial magnetic stimulation, exercise

adjunctive therapy (gabapentin, thyroid meds, ritalin)

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56
Q

initial treatment needed for antidepressants to work

A

6-12 months

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57
Q

long term therapy use of antidepressants considered for

A

multiple episodes of depression, HX suicide, elderly

special considerations: liver/kidney impairment or pregnancy

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58
Q

why do pt need to report headache/palpitations & stiff neck immediately

A

hypertensive crisis

classic symptoms of high blood pressure

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59
Q

with venlafaxine you need to be careful with

A

increased BP

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60
Q

report eye pain immediately because

A

glaucoma

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61
Q

nursing process/pt teachnig

A
  • 2 weeks before therapeutic effects
  • do not stop abruptly
  • careful w/ hypotension
  • managing anticholinergic effects
  • avoid driving if sedated
  • stay out of sun = photophobic
  • sexual dysfunction SSRI
  • wash out periods
  • side effects monitoring
  • suicidal / homicial ideation
  • OTC & prescription meds
  • substance use
  • assess for TD (AIMS)
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62
Q

bipolar I

A

manic episode which may have been preceded by & may be followed by hypomanic or major depressive epsiodes

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63
Q

bipolar II

A

current or past hypomanic episodes & a current or past major depressive episode

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64
Q

cyclothymic

A

episodes consisting of hypomanic and depressive symptoms that do not meet the full criteria for bipolar or major depressive disorder

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65
Q

mania

A

State of abnormally elevated arousal, affect, energy level, heightened overall activation with enhanced affective expression together with lability of affect

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66
Q

lithium salts

A

lithium carbonate, citrate

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67
Q

anticonvulsants

A

lamotrigine, valproic acid, carbamazepine

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68
Q

adjunctive for bipolar

A

antipsychotics, antidepressants, benzo, sedatives & hypnotics

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69
Q

purpose of mood stabilizers

A

stabilize mood (mania & depression)

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70
Q

does it take severeal weeks to reach therapeutic levels for mood stabilizers

A

YES

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71
Q

can other adjunctive meds be used to manage symptoms & behaviours until mood stabilizers reach therapeutic levels

A

YES

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72
Q

1st line tx for acute mania

A

lithium, valproates, 2nd gen antipsychotics, risperidone, aripiprazole, quetiapine, asenapine or combo TX

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73
Q

2nd line tx acute mania

A

olanzapine, ECT

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74
Q

depression 1st line for bipolar

A

lamotrigine, quetiapine, lithium or COMBO

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75
Q

2nd line tx depression for bipolar

A

divalproex, adjunctive SSRIs, bupropion

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76
Q

maintenance bipolar I 1st line

A

monotx w/ lithium, quetiapine (common), divalproex, lamotrigine, aripiprzaole

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77
Q

maintenance for bipolar II

A

quetiapine only recommended 1st line TX for BDII depression

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78
Q

2nd line tx for bipolar II

A

lithium, lamotrigine

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79
Q

body treats lithium like

A

salt

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80
Q

mechanism of action of lithium

A

increases inhibitory GABA neurotransmission & inhibits reuptake of post synaptic excitatory catecholamins (dopamine & norepinephrine)

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81
Q

symptoms of bipolar start to decrease

A

4-14days

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82
Q

max therapeutic response of lithium

A

10-21 days

83
Q

1/2 life of lithium

A

18-20 hr

36hr for elderly

84
Q

contraindications for lithium

A

severe cardiovascular disease, renal disease, sodium depletion, dehydration, diuretics, substance use,

85
Q

NSAIDs, ibuprofen, naproxen does what to lithium

A

increase levels & risk of nephrotoxicity

86
Q

hypernatremia leads to

A

decreased lithium concentrations

87
Q

hyponatremia leads to

A

increased lithium concentrations

88
Q

caffeine, metamucil, bronchial dilators do what to lithium

A

decrease lithium levels

89
Q

N & V, diarrhea, sweating, ACE inhibitors, ARBS, CCBs, NSAIDs do what to kidneys

A

sodium loss leading to kidneys retaining more lithium (therefore increasing lithium levels)

90
Q

target levels of lithium in acute phase mania

A

0.8-1.2mmol/L

91
Q

maintenance levels of lithium

A

0.6-1mEq/L

92
Q

elderly levels of lithium

A

0.4-0.6mEq/L

93
Q

side effects of lithium

A

GI upset, muscle weakness, hand tremor, fatigue, headache, poor concentration & memory, weight gain, acne, hair loss, hypothyroidism, metabolic syndrome, leukocytosis

94
Q

mild to moderate lithium toxicity levels

A

1-2mEq/L

95
Q

side effects of mild to moderate lithium toxicitiy levels

A

diarrhea, vomiting, fatigue, tremors, increased drowisness, uncontrolled movement, blurred vision

96
Q

severe lithium toxicity levels

A

> 2mEq/L

97
Q

symptomsof severe lithium toxicity

A

delirium, slurred speech, seziuers, rapid heart rate, hyperthermia, nystagmus, confusion, kidney failure, coma

98
Q

blood levels drawn how often with lithium

A

once a week initially, then monthly or longer if no problems

99
Q

no withdrawal if lithium stopped abruptly?

A

TRUE

100
Q

lithium pt teaching

A
  • eat reg diet w/ reg amount of Na
  • never double up on dose
  • ensure all physicians aware of lithium
  • report signs of toxicity
  • ensure pt doesn’t take lithium 12hr prior to blood drawns
101
Q

are all anticonvulsants mood stabilizers

A

NO

102
Q

examples of anticonvulsants

A

divalproex, valproic acid, lamotrigine, carbamazepine, topiramate, gabapentin

103
Q

anticonvulsants are used as

A

adjuncts to lithium

104
Q

lamotrigine mechanism of action

A

increases inhibitory GABA neurotransmission

105
Q

indications of lamotrigine

A

epilepsy, bipolar depression acute TX & maintenance

off label use: borderline personality

106
Q

side effects of lamotrigine

A

dizziness, somnolence (strong desire to sleep), diplopia (double vision), headache, nausea, vomiting, diarrhea, rash (steven-johnson syndrome)

107
Q

dosing of lamotrigine

A

titrate slowly to prevent rash

25mg for 2 weeks then 200mg for maintenance

108
Q

valproic acid is most prescribed for

A

epilepsy

109
Q

valproic acid is preferred choice because

A

less side effects, better tolerated & fewer breakthrough manic episodes

110
Q

valproic acid does not

A

prevent/treat depression

111
Q

indications for valproic

A

mixed mania or rapid cycling

effective in treating mania secondary to other medical conditions

more rapid response than lithium

migraine prophylaxis

112
Q

side effects valproic acid

A

transient hair loss, weight changes, tremors, GI upset, somnolence, dizziness, headache, sleep disturbances, metabolic syndrome, thrombocytopenia, hepatotoxicity

113
Q

What is one of the most serious adverse effects of valproic acid

A

hepatotoxicty

114
Q

carbamazepine is

A

absorbed erratically

taken with food and avoid grapefruit

115
Q

mechanism of action of carbamazepine

A

increases inhibitory GABA neurotransmission

anticholinergic

116
Q

indications for carbamazepine

A

effective antimanic agent

effective prophylactic agent

neuropathic pain

epilepsy

117
Q

side effects carbamzaepine

A

sedation, fatigue, dizziness, headache, GI upset, blurred vision, slurred speech

rare but serious: rash, leukopenia, hyponatremia, agranulocytosis

118
Q

seizures

A

Burst of uncontrolled electrical activity between brain cells (also called neurons or nerve cells) that causes temporary abnormalities in muscle tone or movements (stiffness, twitching or limpness), behaviours, sensations or states of awareness

119
Q

convulsions

A

Describes the involuntary action of jerking and contraction

120
Q

epilepsy

A

Chronic recurrent pattern of seizures

121
Q

1st line TX for seizures

A

phenobarbital, phenytoin, carbamazepine

122
Q

barbiturates mechanism of action

A

GABA involvement (inhibits excitement in neuron)

123
Q

side effects barbs

A

sedation, dizziness, drowsiness, lethargy, paradoxical restlessness (awake, restless, opposite effects of sedation)

124
Q

hydantoins: phenytoin is

A

1st line seizures maintenance

125
Q

mechanism of action of phenytoin

A

GABA

126
Q

side effects phenytoin

A

drowsiness, dizziness, lethargy, abnormal movement (ataxia), mental confusion & cognitive changes, rash

127
Q

long term use of phenytoin can cause

A

gingival hyperplasia (gums severely swollen), dilantin facies (subcut tissue of face becomes swollen & thick), osteoporosis

128
Q

toxicity levels of phenytoin can cause

A

nystagmus, ataxia, dysarthria, encephalopathy

129
Q

topiramate & indications

A

chemically related to fructose

epilepsy, mania, rapid cycling

130
Q

topiramate side effects

A

weight loss, word finding difficulties, agitation, fatigue

assess VS & LOC

131
Q

gabapentin

A

increased synthesis & accumulation of GABA (calms neurons)

132
Q

gabapentin indications

A

epilepsy, rapid cycling, BDII, adjunct neuropathic pain or migraines

133
Q

side effects of gabapentin

A

sedation, tremor, hypotension, ataxia, GI upset, weight gain

134
Q

diazepam

A

1st line TX for status epileptics & severe convulsions

used as muscle relaxant & decreasing anxiety

135
Q

clonazepam

A

used to treat absence seizures & treating manic/panic disorders

antiepileptic & mood stabilizers

136
Q

side effects of clonazepam

A

drowsiness, ataxia, hyperactivity, irritability, moodiness, aggressive behaviour changes & personality changes

137
Q

clorzaepate

A

long acting benzo used as adjunct for partial seizures & anxiety & alcohol withdrawal

138
Q

benzo side effects

A

CNS depression, headache, dizziness, lethargy, cognitive impairment, palpitations, dry mouth, physical dependency, withdrawal symptoms, GI upset, grapefruit alters absorption, effects normal sleep so experience hangover effect

139
Q

nursing process for anticonvulsants

A
  • discontinuation must be gradual
  • monitoring side effects
  • notify dr if seizures occur or develop vomiting, weakness, rash
  • may reduce efficacy or oral contraceptives
  • narrow therapeutic range
  • medication adherence
140
Q

painkiller neurotransmitters

A

endorphin & encephalin

bind to opioid receptors in body & give pain relief

141
Q

transduction

A

noxious stimulus causes cell damage with release of sensitizing chemicals & activate nociceptors = generation of action potential

142
Q

transmission

A

action potential continues from :

site of injury –> spinal cord –> brainstem & thalamus –> cortex for processing

143
Q

perception

A

conscious expeirence of pain

144
Q

modulation

A

neurons originating in brainstem descend to spinal cord & release endogenous opioids that inhibit nociceptive impulses

145
Q

neuropathic

A

disruption of function of nerve

146
Q

vascular

A

headache migraine

147
Q

referred

A

injury in one area of your body but feel pain somewhere else

148
Q

phantom

A

occurs in body part that has been removed

149
Q

psychogenic

A

originates from psychological factors not physical

150
Q

threshold

A

Level of stimulus needed to produce a painful sensation

151
Q

tolerance

A

Level of pain a client can endure without it interfering with normal function

152
Q

breakthrough

A

Pain occurs b/w doses of pain medication

Pain the lingers despite the client receiving doses of long acting pain mediation every 12 hr

153
Q

Analgesic ceiling effect

A

What occur when a particular pain drug no longer effectively controls a pt’s pain despite the administration of the highest safest dose

154
Q

opioids

A

Pain-relieving drugs derived from natural opium (unripe seed of opium poopy plant) or produced synthetically

155
Q

Natural alkaloids

A

morphine & codeine

156
Q

semisynthetic

A

hydromorphone & oxycodone

157
Q

synthetic

A

fentanyl, meperidine (not recommended long-term use because accumulation of neurotoxic metabolite), methadone

158
Q

opioid mechanism action

A

Binds to opioid pain receptors in CNS, PNS, & GI tract causes an analgesic response –> reduction in pain sensation

Considered CNS agonist

159
Q

indications of opioids

A

To alleviate moderate to severe pain (> 5/10 pain) when non-opioids are insufficient

160
Q

opioid naive

A

has not used opioids consistently

161
Q

opioid tolerance

A

using opioids begins to experience a reduced response to medication, requiring more opioids to experience the same effect

162
Q

physical dependence

A

state of chronic Dependence on a medication or drug resulting from prolonged abuse

163
Q

psychological dependence

A

emotional and mental processes that are associated with the development of, and recovery from, a substance use disorder or process addiction

164
Q

morphine

A

Relief of moderate to severe pain (above 5/10)

165
Q

codeine

A

Cough relief & analgesia

166
Q

fentanyl

A

Moderate to severe acute pain, relief of persistent pain

167
Q

meperidine

A

Relief of moderate to severe pain (toxic effects)

168
Q

methadone

A

Relief of persistent pain, opioid detox, & opioid addiction maintenance

169
Q

oxy

A

Relief of moderate to severe pain

170
Q

hydromorphone

A

Relief of moderate to severe pain (5-8x stronger than morphine)

171
Q

interactions opioids

A

Alcohol, antihistamines, barbiturates, benzos, phenothiazine, MAOIs

172
Q

Adverse effect & management opioids

A

Nausea & vomiting

Constipation

Sedation, mental clouding, euphoria

Respiratory depression

Itching, rash

Flushing & hypotension

Dry mouth

Urinary retention

Sleep disturbances

Depressed cough reflux

Sexual dysfunction

173
Q

toxicity & management of overdose (opioid antagonists = reversal drugs)

A

naloxone, naltrexone

174
Q

narcan dosing

A

IV push: 0.4-2mg q2-3min

IV infusion: 2mg in 500mL

Nasal spray

THN 0.4mg/mL IM injection

175
Q

regular release opioids

A

Used for acute & breakthrough pain

Can be crushed

Onset: 30-90mins

Duration: 4-6 hr

176
Q

controlled release opioids

A

Drug released slower & steadier into bloodstream

Should not be crushed, chewed, dissolved

Onset delayed

Duration: 8-12hrs

177
Q

Tramadol hydrochloride (opioid like activity)

A

Schedule 1

Centrally acting

Moderate to severe pain

Instant & slow release available

Combined with tylenol – tramacet

178
Q

2 sign side effects tramadol hydrochloride

A

Seizures & serotonin syndrome (when taking SSRIs)

179
Q

side effects of tramadol

A

drowsiness, dizziness, headache, nausea, constipation, RR depression

180
Q

Acetaminophen

A

Mild to moderate pain relief & antipyretic effects

No inflammatory action

Relatively safe nonopioid

Liver toxicity

181
Q

NSAIDs

A

Mild to moderate pain relief

Analgesic, antigout, antinflammatory, antipyretic effects

Adverse GI effects; renal toxicity

ASA antiplatelet agent

182
Q

action tylenol

A

Blocks peripheral pain impulses by inhibition of prostaglandin synthesis

Acts on hypothalamus to lower febrile body temperature – antipyretic

183
Q

indications tylenol

A

Mild to moderate pain & fever

Pain (1-5/10, dental, dysmenorrhea, OA, headache, myalgia)

184
Q

side effects tylenol

A

Rash, nausea, vomiting

Less common

Blood disorders or dyscrasia such as; neutropenia, pancytopenia, leukopenia

185
Q

toxicity tylenol

A

85-90% metabolized by liver & excreted by kidneys

> 4g/day = hepatic toxicity or long term use of large dose more at risk

186
Q

tylenol antidote

A

> 2g/day acetylcysteine = prevents the hepatotoxic metabolites of acetaminophen from forming

187
Q

NSAIDs action

A

Tissue injury > inflammation within leukotriene pathway & prostaglandin pathway; both pathways result in inflammation, edema, headache, other pain characteristics = NSAIDs inhibit these pathways

Block chemical activity of enzyme cyclooxygenase (COX) and/or enzyme lipozygenase (LOX)

188
Q

NSAIDs indication

A

Analgesic, antigout, arthritis, antipyretics effects; vascular headaches, platelet inhibition, post-op pain, dysmenorrhea, tendinitis, bursitis

189
Q

contraindications NSAIDs

A

Allergy, bleeding risk, severe kidney or liver disease

190
Q

Daily ASA tabs (81mg) routinely

A

prophylactic therapy for adults risk of thrombotic events

191
Q

Salicylates used to treat

A

pain resulting from inflammation (arthritis, pleurisy, pericarditis)

192
Q

Salicylates toxicity symptoms

A

Increased heart rate, tinnitus, hearing loss, headache, dizziness, mental confusion, nausea, vomiting, diarrhea, sweating, thirst, hypo/hyperglycemia

No antidote = severe cases may require dialysis

193
Q

Propionic acid derivatives (ibuprofen)

A

Used to treat rheumatoid arthritis, osteoarthritis, primary dysmenorrhea, dental pain, musculoskeletal disorders

Used to treat fever & pain

194
Q

Acetic acid derivatives (indomethacin)

A

Used to treat rheumatoid arthritis, osteoarthritis, acute bursitis/tendinitis, spinal arthritis, acute gouty arthritis

195
Q

Carboxylic acids (salicylates) (ketorolac tromethamine)

A

Unique chemical structure – some anti-inflammatory but mostly analgesic

Short term management of moderate to severe acute pain

Powerful analgesic effect but lacks addictive properties of opioids: good for opioid users

196
Q

COX-2 inhibitors (celecoxib)

A

Used to treat osteoarthritis, rheumatoid arthritis, acute pain symptoms, ankylosing spondylitis & primary dysmenorrhea

Causes fewer adverse GI effects

197
Q

side effects NSAIDs

A

GI (abdominal pain)

Hematological = low platelet function (risk of bleeding)

Hepatic & renal impairment

Skin eruptions (petechiae)

198
Q

Adjunctive therapies

A

Medications from other chemical categories that can be added to the opioid regimen to assist in relieving pain

199
Q

adjunctive therapies include

A

Corticosteroids (dexamethasone, prednisone), anticonvulsant (dilantin, tegretal, gabapentin), tricyclic antidepressants (anitriptiline) & neuroleptics (haloperidol) & olanzepine (chronic pain)

200
Q

benefits adjunctive therapies

A

Allows for use of smaller dosages of opioids

Diminishes some of the adverse effects seen with higher dosages of opioids

Approaches the pain stimulus by another mechanism

201
Q

nursing assessment for pain

A

Pain assessment

Substance use

Lab values

Allergies

Anaphylaxis or overdose

202
Q

Anaphylaxis or overdose = what do I do

A

Presents with decreased LOC & respirations < 8 breaths or anaphylaxis:
Call for help, Do not leave pt, Recumbent position, ABCs, VS, Apply O2 if sats > 98%, Code blue, Support patient

Epi will reduce bronchospasms, counteract histamine vasodilation, increase cardiac output, reduce histamine release

203
Q

nursing interventions for pain

A

Pain flow sheets

Peak of medication (respiratory depression & sedation)

Meperidine restrictions

Pharm & non-pharm interventions

Safety measures to prevent falls

Documentation

204
Q

tylenol 1

A

300 - 8 (codeine) -15 (caffeine)

205
Q

percocet

A

acetaminophen 300, oxycodone 5

206
Q

percodan

A

asa 300, oxycodone 5

207
Q

older adult considerations for analgesics

A

Start low & go slow with amount

Similar pain threshold as other adults

Altered presentations of pain

Under-treatment of pain

Longer duration of effect

Anticholinergic side effects

208
Q

COX2

A

COX = COX1 produces prostaglandins & protect the stomach and intestinal lining (prevent intestinal bleeding)

COX2 = dominant source of prostaglandin in inflammation

209
Q

term used when opioids, non-opioids, and adjunctive medications used together

A

multimodal

210
Q

tylenol 2,3,4

A

Tylenol #2 300-15 (codeine) -15 (caffeine)
Tylenol #3 300-30-15
Tylenol #4 300-60-none

pharm (4 decks)

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