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PHARM > Pain, Fever, ANS prototypes > Flashcards

Pain, Fever, ANS prototypes Flashcards

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1
Q

atropine therapeutic class

A

anti-arrhythmic, bronchodilator

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2
Q

atropine pharmacologic class

A

anticholinergic (antimuscarinic)

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3
Q

action of atropine

A

inhibits the effects of the parasympathetic nervous system: increase in HR, bronchodilator, decreases GI and respiratory secretions

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4
Q

side effects of atropine

A

dry mouth, urinary retention, blurred vision, tachycardia, headache, fatigue, constipation

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5
Q

uses of atropine

A

decreases GI & respiratory secretions; use treatment of asthma/COPD; use for treatment of bradycardia

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6
Q

nursing considerations of atropine

A

avoid in acute hemorrhage, tachycardia, angle closure glaucoma

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7
Q

bethanechol therapeutic class

A

treatment of urinary retention

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8
Q

bethanechol physiological class

A

cholinergic, EX. direct-acting parasympathomimetic

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9
Q

action of bethanechol

A

directly stimulates muscarinic receptors: increasing the tone of the destrusor urinate muscle (smooth muscle) of the bladder, giving a contraction adequately effective to initiate micturition (peeing) and void (empty) the bladder

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10
Q

use of bethanechol

A

post-operatively (non-obstructive) urinary retention; neurogenic bladder (spinal cord injury or shock)

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11
Q

adverse effects of bethanechol

A

increased salivation, sweating, abdominal cramping and hypotension (could lead to fainting)

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12
Q

contraindications of bethanechol

A

do not give to pts. with asthma, epilepsy, Parkinson’s, peptic ulcer disease, bradycardia.

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13
Q

phenylephrine therapeutic class

A

nasal decongestant, antihypotensive

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14
Q

phenylephrine pharmacologic class

A

adrenergic drug (sympathomimetic); selective, alpha-adrenergic agonist

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15
Q

intranasal action of phenylephrine

A

reduces nasal congestion by constricting small blood vessels in nasal mucosa

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16
Q

intranasal contraindications of phenylephrine

A

do not use for than 5 days due to rebound congestion

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17
Q

topical action of phenylephrine

A

used in eye drops to cause pupil dilation

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18
Q

topical contraindications of phenylephrine

A

do not use in those with narrow angle glaucoma

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19
Q

parenteral action of phenylephrine

A

can reverse hypotension due to spinal anesthesia or vascular shock; lack of beta selectively (few cardiac side effects)

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20
Q

parenteral contraindications of phenylephrine

A

use in caution in those with advanced coronary artery disease, hypertension or hyperthyroidism
Black Box Warning: severe reactions including death may occur with IV infusion; use with cation and only when other routes are not feasible

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21
Q

antidote of phenylephrine

A

phentolamine (alpha-blocker) — may need to treat hypertension

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22
Q

prazosin therapeutic class

A

anti-hypertensive

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23
Q

prazosin pharmacologic class

A

adrenergic-blocking drug

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24
Q

actions of prazosin

A
  • alpha-1 adrenergic antagonist that competes with NE at its receptors on smooth muscles in arterioles and veins
  • a rapid decrease in peripheral resistance that reduces blood pressure
  • little effect on CO or HR
  • used mostly in combination with beta-blocker
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25
adverse effects of prazosin
- can cause orthostatic hypotension, can cause unconsciousness about 30 mins after 1st dose - 1st dose should be low and given @ bedtime - dizziness, drowsiness, and lightheadedness - reflex tachycardia could occur due to rapid drop in BP - use cautiously with other anti hypertensives and diuretics
26
NSAIDs
Non-Steroidal Anti-Inflammatory Drugs
27
ibuprofen therapeutic class
anaglesic, anti-inflammatory, anti-pyretic
28
ibuprofen pharmacologic class
NSAID, non-selective COX inhibitor
29
action of ibuprofen
inhibits the conversion of arachidonic acid to cyclooxegenase (COX) which inhibits the production of prostaglandins *prostaglandins generated by COX-1&2 can be both protective (COX-1) and cause inflammation (COX-2)
30
use of ibuprofen
mild to moderate pain, treatment of fever, treatment of inflammation
31
nursing considerations of ibuprofen
- may cause/exacerbate GI bleeding (due to inhibition of COX-1) and peptic ulcers (should avoid patients with peptic ulcers) - monitor for bleeding (inflammation) - observe or elicit signs/symptoms of GI distress (nausea, vomiting, heartburn, epigastric pain) - monitor hepatic & renal function - has cross-sensitivity with aspirin in terms of allergy/anaphylaxis -- patients with aspirin allergy (itching, rhinitis, bronchospasm, angioedema) should not take ibuprofen
32
aspirin therapeutic class
anaglesic, anti-inflammatory, anti-pyretic
33
aspirin pharmacologic class
NSAID, salicylate, non-selective COX inhibitor
34
action of aspirin
inhibits the synthesis of prostaglandins
35
use of aspirin
mild to moderate pain, treatment of fever, treatment of inflammation, may prevent stroke and heart attack
36
nursing considerations for aspirin
- GI irritation (take with food or enteric-coated -- i.e. milk) - use in caution with other drugs that increase risk of bleeding (warafin, heparin and clopidogrel) - monitor hepatic renal function - may lead to Stevens-Johnson syndrome, can cause laryngeal edema, anaphylaxis -do not use in children (combined with viral illness can cause Reyes Syndrome)
37
acetaminophen therapeutic class
anaglesic, anti-pyretic
38
acetaminophen pharmacologic class
anaglesic
39
action of acetaminophen
inhibits the synthesis of prostaglandins in the brain
40
use of acetaminophen
mild to moderate pain (often used in combination with an opioid), treatment of fever
41
nursing considerations for acetaminophen
- ensure correct dose administered as recommended => do not exceed daily maximum dose of 3000mg/day for adults. pediatric patients total daily max is dependent on weight. - hepatotoxic -- ensure correct dosing. do not use in patients with hepatic insufficiency or those who drink more than 3 alcoholic drinks/day
42
morphine therapeutic class
anglesic
43
morphine pharmacologic class
opioid agonist
44
action of morphine
works in the brain to inhibit pain sensation
45
uses of morphine
uses moderate to severe pain not relieved by non-opioid medications, air hunger - decreases labored breathing - helps with pain while on deathbed - ease of breathing
46
nursing considerations for morphine
- monitor for respiratory depression, sedation, urinary retention, nausea/vomiting, constipation - assess BP, pulse and respiratory rate prior to administration an during administration - administer stool softener (if prescribed) to avoid constipation. consider requesting PRN order for stool softener if not ordered. - discontinue use of opioids once pain can be managed by non-opioid medications. Potential for addiction/abuse. - requires 2 RN verification and signature -- also needed for meds to be wasted or discarded.
47
naloxone therapeutic class
reversal agent, antidote for opioids
48
naloxone pharmacologic class
CNS opioid receptor antagonist
49
action of naloxone
competes with opioids at the receptor site in the brain
50
use of naloxone
reversal of opioid intoxication or overdose
51
nursing considerations of naloxone
- have drug available if administering opioids (especially a PCA or continuous IV admin) - administration may cause sudden withdrawal symptoms (nausea, vomiting, diarrhea, fever, sweating, body aches, crying, irritability) - administration may reveal underlying pain, be prepared to administer pain medication
52
methadone therapeutic class
opioid analgesic
53
methadone pharmacologic class
long-acting opioid agonist
54
action of methadone
works in the brain to desensitize multiple pain receptors, blocks cravings and euphoria
55
use of methadone
used to treat opioid use disorder or to facilitate medical withdrawal, sometimes used in chronic pain management
56
nursing considerations for methadone
- may be used to facilitate opioid withdrawal after an ICU stay - same monitoring as morphine => can cause respiratory depression - usually given as a taper over time - watch for withdrawal symptoms (nausea, vomiting, diarrhea, fever, sweating, body aches, crying, irritability) -- may need to advocate for slower taper.
57
sumatriptan therapeutic class
vascular headache (migraine) suppressant
58
sumatriptan pharmacologic class
serotonin (5-HT) agonist
59
action of sumatriptan
causes vasoconstriction of blood vessels in the head
60
use of sumatriptan
migraine headache treatment
61
nursing considerations of sumatriptan
- not preventative, can only work once a headache has started - do not use in patients with angina or history of myocardial infarction - do not give if patient is taking ergotamine-based medications (also a 5-HT agonist) - may cause mild sedative effects - some patients experience a "triptan rush" -- sense of tingling, soreness, tenderness of scalp/face/neck -- transient - goals for migraine treatment: 1) stop headache 2) prevent future headaches
62
prednisone therapeutic class
potential anti-inflammatory
63
prednisone pharmacologic class
corticosteroids (or steroids)
64
action of prednisone
decreases inflammation and suppresses immune system
65
use of prednisone
to treat allergic disorders, skin conditions, lupus, ulcerative colitis, Crohn's disease, arthritis, psoriasis, asthma, COPD, and many other conditions.
66
nursing considerations for prednisone
- may cause Cushing's syndrome - do not use in someone with active infection - causes GI distress (take with food), can lead to peptic ulcer formation) -- may need to be on a GI protective drug
67
lidocaine therapeutic class
anesthetic, anti-dysrhythmic
68
lidocaine pharmacologic class
sodium channel blocker
69
action of lidocaine
most used local anesthetic, blocks neuronal pain impulses by blocking sodium channels located within the neuronal membranes
70
uses of lidocaine
IV - used a nerve block for spinal and epidural anesthesia; dysrhythmias Patches - relieve pain related to neuralgia or dental procedures Intradermal - rapid local pain relief
71
nursing considerations for lidocaine
averse effects are uncommon, early signs include symptoms of CNS stimulation, such as restlessness and anxiety, then turn to CNS depressant - monitor for hypotension and dysrhythmias - monitor patients with history or cardiovascular disease and lidocaine with epinephrine

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