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NURS 50A Pharmacology in Nursing Part I > Pain > Flashcards

Pain Flashcards

1
Q

acute

A

1 sec - <6 months

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2
Q

chronic

A

> 6 months

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3
Q

somatic

A
  • actual injury

- localized pain from peripheral nociceptors activation w/o injury to peripheral nerve or CNS

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4
Q

nociceptive

A

stimulation of peripheral nerve fibers that respond to stimuli approaching or exceeding harmful intensity

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5
Q

neuropathic

A

lesions/dz affecting somatosensory system

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6
Q

visceral

A

internal organs

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7
Q

analgesic

A

relieves pain

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8
Q

narcotic

A

any analgesic, CNS depressant, or other drug that may cause physical dependence

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9
Q

opiate/opioid

A

endogenous opioid-peptides, synthetic, or semisynthetic which have similar actions to morphine

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10
Q

tolerance

A
  • larger dose required to produce same effect

- cross-tolerance: tolerance to another drug in same class

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11
Q

physical dependence

A
  • withdrawal sx if drug stopped abruptly

- body requires continued presence of drug to fxn nml

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12
Q

addiction

A
  • continued use of drug despite physical, psych, or social harm
  • behavioral
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13
Q

abuse

A

-intentional misuse of drugs inconsistent w/ medical or social norms

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14
Q

morphine (MS Contin)

A
  • action: opioid agonist analgesic
  • use: analgesic; anxiety; sedation; sense of well being
  • precautions: respiratory suppression; decreased uterine contraction, fetal depression; biliary colic; miosis
  • adverse effects: constipation; cough suppression (post-op pna risk)
  • considerations: dilute and push slowly
  • drug interactions: intensifies ae’s of alcohol, barbiturates, benzos
  • antidote = naloxone
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15
Q

meperidine (Demerol)

A
  • action: opioid analgesic; local anesthetic
  • use: drug induced rigors; post anesthesia shivering; alt to other opioids
  • precautions: normeperidine metabolite is toxic; NTE >600 mg/24hr for >2 days
  • differences w/ morphine: less resp depression, constipation, and vomiting; less apt to release histamine or increase biliary tract pressure; shorter duration of action; poor oral bioavailability
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16
Q

naloxone (Narcan)

A
  • action: opioid antagonist
  • use: reversal of opioid OD
  • precautions: give IV, IM, sub-Q (PO has high first-pass effect); given prior to opioid will block opioid action; acute withdrawal effect
  • considerations: maintain open airway and be prepared to provide artificial ventiltion and cardiac support

-addiction tx: PO given at 50 mg/day

17
Q

hydrocodone bitartrate and acetaminophen (Vicodin, Norco)

A
  • actions: opioid combo
  • use: analgesic and antipyretic
  • adverse effects: resp dep; hepatotoxicity; abuse
  • drug interactions: amiodarone (inhibitor); barbiturates, Tegretol (inducers)
  • considerations: avoid abrupt cessation
18
Q

methadone (Methadose)

A
  • actions: opioid analgesic; similar to morphine
  • use: relieve severe/chronic pain
  • precautions: severe dysrhythmias prolongs QT interval, V-fib; resp suppression
  • considerations: EKG for chest pain
  • drug interactions: sertraline, rifampin (inhibitors); Tegretol, phenobarb, phenytoin, barbiturate anesthetics (inducers); caution w/ many HIV ARVs
  • methadone maintenance: sub methadone for opioid; admin gradually in smaller doses
  • methadone suppression: prevents opioid induced euphoria by giving addicts larger doses of methadone (>100 mg/day)
19
Q

alcohol

A
  • action: CNS depressant; enhances serotonin; binds w GABA receptors
  • precautions: tolerance; dose dependent (thiamine deficiency)
  • adverse effects: damage to myocardium, HTN; resp dep; liver damage, cirrhosis, cancer; erosive gastritis, varices; brease and colorectal cancer
  • interactions: NSAIDs can cause liver damage w/ 2-4 drinks/day (NSAID limit NTE 2g/day

CAGE

  • Cut down - have you ever thought about cutting down?
  • Annoyed - hav people annoyed you by criticizing?
  • Guilty - have you ever felt guilty?
  • Eye opener - have you ever had a drink the first thing in the morning to steady your nerves or get rid of a hangover?
  • alcohol withdrawal = sx that occur d/t physiologic response to alcohol dependence
  • -low dependence: 12-24 hr/ anxiety, disturbed sleep, nausea, mild tremors, weakness
  • -high dependence: 12-72 hr/ cramps, NV, intense tremors, tachy, HTN, fever
  • -severe dependence: delirium tremens (DTs)- hallucinations, disorientation, tremors, sz
  • alcohol withdrawal management
  • -benzos: dec sx; stabilize VS; prevent sz
  • -beta-adrenergic blockers: improve VS; dec autonomic component
  • -alpha-adrenergic blockers: improve VS; dec autonomic component
20
Q

chlordiazepoxide (Librium)

A

use: anxiety; acute alcohol withdrawal; pre-op relaxation

21
Q

lorazepam (Ativan)

A

-precautions: renal/hepatic dz; addiction

22
Q

alprazolam (Xanax)

A

-use: anxiety; panic disorders

23
Q

diazepam (Valium)

A
  • use: IV for status epilepticus; anxiety; insomnia; muscle spasm; alcohol withdrawal
  • precautions: inject slowly into a large vein flush w/ NSS pre/post
24
Q

benzo drug interactions

A

alcohol; CNS depressant; opioid analgesics; anesthetics; tricyclic antidepressants

NURS 50A Pharmacology in Nursing Part I (4 decks)

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