Non-Opioids

Question 1

Purpose

Answer 1

Anti-inflammatory
Anti-pyretic (fever)
Analgesic

Question 2

NSAIDs: MOA

Answer 2

-inhibition of cyclooxygenase (COX)
-inhibition of COX-1: decreased platelet aggregation and kidney damage
-inhibition of COX-2: decreased inflammation, fever, and pain

Question 3

NSAIDs: Therapeutic responses

Answer 3

-inflammation suppression
-analgesic for mild to moderate pain
-fever reduction
-dysmenorrhea
-inhibit platelet aggregation= decrease risk of stroke or MI (aspirin)
-Celecoxib: COX-2 inhibitor only, suppress inflammation, relieve pain, decrease fever, protect against colorectal cancer

Question 4

NSAIDs: Complications

Answer 4

-GI issues: dyspepsia, abdominal pain, heartburn, nausea
-Kidney issues: decrease urine output, fluid retention, increase BUN and creatinine levels
-increased risk of MI and stroke with non-aspirin NSAIDs (use smallest effective dose)
-Salicylism: tinnitus, sweating, dizziness, headaches, respiratory alkalosis
-Reye’s syndrome: rare
-Aspirin toxicity: salicylism to sweating, high fever, acidosis, dehydration, electrolyte imbalance, coma, respiratory depression

Question 5

NSAIDs: Ketorolac (Toradol)

Answer 5

Do not use longer than 5 days, decrease does or don’t use in kidney disease

Question 6

NSAIDs: Celecoxib

Answer 6

-2nd generation selective COX-2 inhibitor
-increase risk of MI or stroke (suppresses vasodilation)
-don’t give to patients with sulfonamide drug allergy

Question 7

Acetaminophen (Tylenol): MOA

Answer 7

Slows production of prostaglandins in CNS

Question 8

Acetaminophen (Tylenol): Therapeutic responses

Answer 8

-analgesic
-antipyretic
-okay in peds with viral symptoms

Question 9

Acetaminophen (Tylenol): Complications

Answer 9

-Liver damage: monitor N/V/D, diaphoresis, RUQ abd pain, hepatic failure, coma, death, starts to appear 2-3 days after use
-antidote: acetylcysteine

Nursing actions: do not exceed recommended dosage