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Skeletal and pain meds Flashcards

(45 cards)

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1
Q

NSAIDS:

A

*ibuprofen (Advil/Motrin)
*Stop prostaglandin synthesis
*Act on the periphery
*use: antipyretic, analgesic
*Adverse: GI bleeding, thrombotic events, MI, stroke

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2
Q

aspirin

A

-NSAID (except low-dose ASA)
-SALICYLATE
-may cause GI distress and bleeding

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3
Q

Centrally Acting Nonopioid antipyretic, anti-inflammatory, analgesic

A

*acetaminophen
*Not an NSAID, CNS med
*Black Box Warning: fatal liver injury
*monitor level <3,000mg/day
*Unlike aspirin and related drugs, it does not irritate the stomach.
*preferred drug for fever

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4
Q

Nursing considerations for NSAIDS, Steroids and Antipyretic Medications

A

*Pain assessment
*Monitor for GI bleeding
*Lab work: Liver enzymes, salicylate levels, blood sugar levels

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5
Q

NSAIDS decrease prostaglandin production in the stomach, increasing the client’s risk of __________

A

developing ulcers.

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6
Q

Neuropathic pain

A

*Caused by direct injury to the nerve
*Responds less successfully to conventional pain medications than nociceptor pain

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7
Q

what’s somatic pain?

A

sharp localized sensations

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8
Q

what’s visceral pain?

A

generalized dull and internal
throbbing or aching pain

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9
Q

Two major classes of drugs to manage pain:

NSAIDs act ____________

Opioids act ____________

A

NSAIDS: at the peripheral level

Opioids: within the CNS

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10
Q

Adjuvant analgesics (co-analgesics):

A

*Anti seizure drugs (gabapentin)
*Local anesthetics
*Anesthetic nerve blocking drugs

*Off-label medications: Tricyclic antidepressants (TCAs)

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11
Q

For pain management with opiods, ___________________ are most important

A

mu and kappa receptors

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12
Q

Opioid (Narcotic) Agonist

A

*Morphine
*MOA: binds with mu and kappa receptor sites to produce profound analgesia
*Use: analgesia & anesthesia
*Adverse: respiratory depression, sedation, N/V
*monitor kidney/liver function

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13
Q

systemic corticosteroids

A

*prednisone (betamethasone)
*MOA: suppress immune system to treat inflammation
*Adverse: Long-term therapy may result in Cushing syndrome, elevate blood glucose, mask infections
*taper on & off

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14
Q

Opioid Antagonists

A

*naloxone (Narcan)
*Use: to reverse respiratory depression and other acute symptoms of opioid addiction, toxicity, overdose

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15
Q

Selective COX-2 Inhibitors

A

*celecoxib
*MOA: similar to the NSAIDs
*Use: analgesic antipyretic, anti-inflammatory
*Adverse: mild and related to GI system

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16
Q

Centrally Acting Nonopioid Analgesics

A

*acetaminophen & tramadol

TRAMADOL
*MOA: weak opioid activity
*Use: a CNS-acting analgesic
*Adverse: CNS, GI and CV effects

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17
Q

Nursing Considerations for Opioid Use

A

*Pain Assessment
*Monitor use to avoid dependence
*Monitor depth and rate of respirations
*Have naloxone (Narcan) available
*Neuro assessment

Lab work
*Liver function
*Renal status

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18
Q

triptans

A

*sumatriptan
*First choice for migraines
*Constrict blood vessels in the brain
*Use: to abort migraines
*Adverse: GI upset, dizziness, drowsiness

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19
Q

Ergot alkaloids

Study These Flashcards
A

*ergotamine tartrate
*migraine med for patients unresponsive to triptans
*Used to terminate ongoing migraines
*Adverse: : GI upset, weakness in the legs, myalgia, numbness and tingling in fingers and toes, angina-like pain, tachycardia

20
Q

Other migraine drugs

Study These Flashcards
A

*Beta-blockers (propranolol)
*calcium channel blockers
*antidepressants
*antiseizure drugs
*neuromuscular blockers

21
Q

Parkinson’s:

s/s ________________________

meds to treat: _____________

Study These Flashcards
A

*s/s: shaky, pill rolling, rigid muscles, masked face, bradykinesia, difficult to chew/swallow/speak, shuffling feet, humped posture, balance issues

*meds: dopaminergic (levodopa-carbidopa) & anticholinergics (benztropine)

22
Q

Dopaminergic agents:

Study These Flashcards
A

*carbidopa–>levodopa–>(dopamine)
*treats Parkinson’s s/s
*MOA: increases biosynthesis of dopamine
*Adverse: hypotension, anorexia, N/V, depression
**educate to decrease protein consumption

23
Q

Anticholinergic agents:

Study These Flashcards
A

*benztropine
*treats Parkinson’s s/s
*MOA: block ACh excitability
*Use: in early stages
*Adverse: dry mouth, blurred vision, photophobia, urinary retention, constipation, tachycardia, glaucoma

24
Q

*natural treatment for Alheimer’s

Study These Flashcards
A

*Ginkgo Biloba
Improves mental functioning, stabilizes AD by increasing blood supply to the brain
****Can increase the risk for bleeding

25
Alzheimer’s Disease (AD) s/s: _______________________ meds: ____________________ natural treatments: _______
*s/s: cause unknown, ACh decreases *Impaired memory and judgment, confusion or disorientation, inability to recognize family or friends, aggressive behavior, depression, paranoia, delusions, and anxiety *meds: Cholinesterase Inhibitors - acetylcholinesterase inhibitors (donepezil)
26
Cholinesterase Inhibitors (aka Ach inhibitors)
*donepezil (Tacrine) *slows progression of AD *MOA: Intensify effect of acetylcholine at cholinergic receptor *Adverse: N/V, chest pain, diarrhea, HA, abnormal dreams, irritability, darkened urine, hepatotoxicity, renal toxicity *ineffective in late stages
27
multiple sclerosis etiology: treatment: drugs:
*etiology: unknown, no cure *Possible causes: Genetics, microbial factors, colder regions *strategies for treatment: Reduce inflammation, prevent attacks on nervous system, address impairment of movement *Drugs: Immune system modulators, steroids
28
centrally acting skeletal muscle relaxants
*for muscle spasms *cyclobenzaprine *provides short term relief by depressing motor activity in brainstem - ALTERS REFLEXES *adverse: drowsiness, blurred vision, dry mouth
29
direct acting muscle relaxers
*for muscle spasms *dantrolene sodium *blocks the release of calcium from muscle tissue to stop the muscle fiber from contracting *muscle weakness, dry mouth, dizziness, photosensitivity *avoid driving, report palpitations or slurred speech
30
muscle spasms Define: _______________ Treatment: _______________
*they are involuntary contractions of muscles leading to diminished level of functioning 1. Tonic spasm - single prolonged contraction 2. Clonic spasm - jerking or twitching *Drugs: centrally acting skeletal muscle relaxants (cyclobenzaprine), direct acting antispasmodics (dantrolene sodium)
31
Bone and Joint Disorders
*Osteoporosis *Osteomalacia *Paget’s Disease *Arthritis *Gout
32
Osteomalacia what is it? most frequent cause of it? who is affected?
*An abnormality of new bone formation (osteoid) causing bones to become increasingly soft, flexible, brittle, and deformed *deficiency of vitamin D and calcium in the diet *prevalent in the older adult, preemies, ppl on strict vegetarian/vegan diets *in children it is called rickets
33
Pharmacotherapy of Osteomalacia
*Calcium supplements, Vit D *Calcitriol for rickets (usually in combination with calcium supplements)
34
Vitamin D Therapy
*calcitriol *MOA: its the active form of vitamin D, promotes absorption of calcium, reduces bone reabsorption, elevates serum levels of calcium *Use: for impaired kidney function, hypo-parathyroidism, treating rickets *Adverse: hypercalcemia, HA weakness, dry mouth, thirst, polyuria, muscle/bone pain
35
Role of the Nurse: Calcium Supplement Therapy
Assess for signs and symptoms of hypercalcemia: Drowsiness, lethargy, weakness, HA, anorexia, N/V, thirst, polyuria
36
Bisphosphonates
*alendronate *for osteoporosis *MOA: Lowers serum alkaline phosphate, an enzyme important to bone turnover *Use: to prevent and treat osteoporosis & Paget disease *Adverse: diarrhea, N/V, GI irritation, metallic- or altered-taste perception; pathologic fractures with long-term use (fracture that occurs w/out trauma)
37
Selective Estrogen Receptor Modulators (SERM)
*reloxifene *for osteoporosis prevention *MOA: decreases bone resorption, Increases bone mass and density r *Adverse: hot flashes, migraines, flu-like symptoms; endometrial disorder, breast pain, vaginal bleeding; may cause fetal harm if pregnant
38
natural therapies for arthritis
*Glucosamine/Chondroitin *Helps build cartilage
39
Gout Goals: _________________ Treatment: _____________
*Goals: termination of acute attacks; prevention of future attacks *NSAIDS for pain and inflammation *Corticosteroids for more severe pain and inflammation
40
uric acid inhibitor
*allopurinol *reduces gout inflammation *MOA: inhibits synthesis of uric acid *Adverse: rashes, Stevens-Johnson syndrome, hypersensitivity syndrome, drowsiness, HA, vertigo, N/V, abdominal discomfort, malaise, diarrhea, retinopathy, thrombocytopenia
41
Nursing Considerations for Bone and Joint Medications
*Lab work (Electrolytes and uric acid level *Radiology: X-rays, Dexascan *Educate: avoid foods high in purine and get plenty of calcium and Vitamin D
42
Centrally Acting Skeletal Muscle Relaxants
*cyclobenzaprine *MOA: inhibits upper-motor-neuron activity, causes CNS depression, alters simple spinal reflexes *Use: to treat localized spasms *Adverse: CNS depression, hepatic toxicity, physical dependence, anticholinergic effects
43
Rheumatoid Arthritis (RA) Treatments
*Analgesics and anti-inflammatories *Short-term therapy with corticosteroids and glucocorticoids if inflammation is severe *Disease-modifying antirheumatic drugs (DMARDs) like hydroxychloroquine
44
Oxycodone Hydrochloride vs Combination Acetaminophen and Codeine (Mild Opioid)
Oxycodone Hydrochloride =Strong Opioid Acetaminophen and Codeine =Mild Opioid
45
parkinsons
dopamine being destroyed in CNS & Ach (stimulatory) takes over

Pharm (8 decks)

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