Pain Management and Anti-inflammatory Drugs Flashcards
(25 cards)
What is the opioids morphine used for?
Strong agonist- severe pain, used to control postoperative and other types of pain. First line analgesics in immediate post setting.
What is the opioids dilaudid used for?
Strong agonist- severe pain, also immediate postop, 7xs stronger than morphine.
What are the adverse effects of opioids?
Orthostatic hypotension, miosis (pupil constriction), urinary retention, constipation, respiratory depression
What are the contraindications of opioids?
Biliary tract surgery, severe asthma, pts with head injury, sleep apnea, paralytic ileus
What are the interactions of opioids?
Alcohol, antihistamines, barbiturates, benzodiazepines, and other CNS depressants
What are the nursing responsibilities for of opioids?
Assess pain, therapeutic and adverse effects, watch for respiratory depression, get up slowly, ensure safety measures.
What is the treatment for an opioid overdose?
Naloxone (Narcan)- reverses respiratory depression (IV onset 2 minutes, duration 1 hour)
What is the mechanism of action for acetaminophen?
Selective inhibition of cyclooxygenase (COX) in the CNS
What is the drug effect for acetaminophen?
Analgesic (pain reliever)
Antipyretic (fever reducer)
What are the indications for acetaminophen?
Fever
Mild to moderate pain
Alternative for those who can not use aspirin
What are the adverse effects for acetaminophen?
Nausea, vomiting, hepatotoxicity, nephrotoxicity
What are the contraindications for acetaminophen?
Alcohol, severe liver disease, G6PD disease
What are the interactions for acetaminophen?
Alcohol, phenytoin, barbiturates, warfarin, isoniazid, rifampin, beta blockers, and anticholinergic
What are the nursing responsibilities for acetaminophen?
Pain assessment, assess for comorbidities, lab values, s/s for chronic poisoning, s/s for hepatotoxicity
What is the pt edu for acetaminophen?
Teach pts to read labels to evaluate all medications for acetaminophen content and determine the amount in each dose. It is found in many combination drugs like Norco, Vicodin, NyQuil
What is the overdose and treatment for acetaminophen?
Overdose can cause hepatic necrosis caused by ingesting doses 150mg/kg or more and may result in hepatotoxicity.
The antidote is acetylcysteine (Mucomyst)
Substitute for depleted glutathione, prevents hepatotoxic metabolites of acetaminophen from forming
Dosing: loading dose of 140 mg/kg orally, followed by 70 mg/kg every 4 hours for 17 additional doses
What is the mechanism of action for NSAIDS (aspirin, ibuprofen)?
Blocks the chemical activity of the enzyme called COX.
What is the drug effect for NSAIDS (aspirin, ibuprofen)?
Analgesic, anti inflammatory, antipyretic, antiplatelet, antirheumatic
What are the indications for NSAIDS (aspirin, ibuprofen)?
Mild to moderate pain, arthritis, fever, inflammation, muscle strains, dysmenorrhea, inhibition of platelet aggregation which protects against ischemic stroke and MI (aspirin)
What are the adverse effects for NSAIDS (aspirin, ibuprofen)?
Gastric ulcers, GI bleeding, renal failure, increased risk for MI with non-aspirin NSAIDS
What are the black box warnings for NSAIDS (aspirin, ibuprofen)?
MI, stroke, bleeding
Don’t give aspirin to children with a viral disease
What are the contraindications for NSAIDS (aspirin, ibuprofen)?
Peptic ulcer disease, bleeding disorders, severe renal or hepatic disease, third trimester of pregnancy, children with viral disease
What are the interactions for NSAIDS (aspirin, ibuprofen)?
Alcohol, anticoagulants, corticosteroids, concurrent use of other NSAIDS
What are the nursing responsibilities for NSAIDS (aspirin, ibuprofen)?
Pre-administration assessment, obtain list of other meds, assess comorbidities, lab values, pain assessment, assessment of decrease in swelling, stiffness, tenderness
