Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
What are non-opioid analgesics mechanism of action?
|
non-opioid analgesics are peripherally acting
(fingers, toes) |
|
|
What are narcotic/opioid analgesics mechanism of action?
|
opioid analgesics are centrally acting
(CNS system) |
|
|
What are the main types of non-opioid analgesics?
|
steroidal anti-inflammatory drugs (glucocorticoids/corticosteroids)
NSAIDS (nonsteroidal anti-inflammatory drugs) Tylenol |
|
|
What does itis mean?
|
inflammation
|
|
|
What is acute inflammation?
|
resolves w/in 8-10 days
|
|
|
What is chronic inflammation?
|
may continue for months or years
|
|
|
What do mediators of the body cause when inflammation occurs?
|
vasodilation
increases capillary permeability (fluid leaks out of blood) stimulation of nociceptors |
|
|
What are the 5 signs of inflammation?
|
heat
edema loss of function pain redness |
|
|
What is prednisone?
|
prednisone is a steroidal anti-inflammatory drug
|
|
|
What is prednisone used for?
|
used for anti-inflammatory
used for transplant pts to depress immune system used to treat certain cancers used to treat adrenal insufficiency |
|
|
What does prednisone do to WBCs?
|
inhibits WBC function
|
|
|
What are some contraindications for steroidal anti-inflammatory drugs?
|
active infections (fungal, viral, bacterial), administration of live virus vaccines
b/c of their lowered immune system |
|
|
Who should be cautioned before using steroidal anti-inflammatory drugs?
|
pts w/ HIV, cancer, TB, congenital immunodeficiency
|
|
|
What are the side effects of steroidal anti-inflammatory drugs?
|
hyperglycemia
mood changes gastrointestinal ulcers, GI bleeds fluid and electrolyte imbalance HTN susceptibility to infection osteoporosis delayed wound healing potential to mask s/s of infection adrenal insufficiency increased appetite bruising cataracts cushing's syndrome (buffalo hump, moon face, central obesity, facial hair, acne) |
|
|
What should you monitor for w/ a pt taking steroidal anti-inflammatories?
|
side effects!
s/s of GI bleed, hyperglycemia, HTN, electrolyte imbalances monitor complete blood count (CBC) taper dose as ordered |
|
|
What should you teach a pt taking steroidal anti-inflammatories?
|
take med. as directed at at same time of day
do not discontinue abruptly take w/ food avoid people w/ known infections immediately report: s/s of infection, increased thirst or urination, severe mood swings, unusual bleeding monitor BP avoid vaccines unless approved by physician monitor blood sugars |
|
|
What is the most common salicylates?
|
aspirin (ASA)
|
|
|
What kind of drug is aspirin?
|
NSAIDS
|
|
|
What would the dosage be for a pt taking aspirin to decrease the risk of blood clots?
|
81 mg daily
|
|
|
What would be the dosage for a pt taking aspirin to relieve pain?
|
325-650 mg
|
|
|
ASA is an
|
analgesic, anti-inflammatory and antipyretic
|
|
|
What are some contraindications for the use of ASA?
|
hypersensitivity (pts w/ asthma)
children < 18 are at risk for Reye's syndrome pts w/ bleeding disorders, decreased platelets |
|
|
What are some interactions w/ ASA?
|
use w/ caution w/ anticoagulants
|
|
|
What are the adverse/side effects of ASA?
|
GI bleed, nausea, abd. pain
|
|
|
What would you assess before giving a pt ASA?
|
assess for GI bleeding and the use of anticoagulants
|
|
|
What should be done w/ ASA before surgery?
|
usually d/c 7 days prior to process b/c it changes the cell membrane of platelets
|
|
|
What should you teach a pt taking ASA?
|
not for children < 18
enteric coating (no crushing) take w/ food avoid etoh do not take w/ tylenol or other NSAIDS for > 3 days (kidney damage) disintegrates w/ time, heat, moisture report signs of GI bleed/ bleeding (melena- black stool, bleeding gumsm, petechia- capillary hemorraging, ecchymosis- bruising) stop taking 1-2 wks before surgery or dental work hidden sources of ASA: excederin, pepto-bismol |
|
|
What kind of drug is ibprofen?
|
NSAIDS
|
|
|
Who should not take ibprofen?
|
pts w/ severe renal/hepatic disease, PUD, active GI bleeding
|
|
|
What are some side/adverse effects of ibprofen?
|
abd. pain, N/V, GI bleed, fluid retention, and nephropathy
|
|
|
What should you teach a pt taking ibprofen?
|
take w/ food or full glass of water
be aware of various strengths; do not use > 3600 mg/day signs of GI bleeding avoid taking w/ ASA avoid etoh report unrelieved pain or greater pain after 10 days report unrelieved or greater fever after 3 days pts w/ asthma or allergy to ASA are at > risk for hypersensitivity to ibprofen |
|
|
What kind of drug is celebrex?
|
NSAIDS
cox-2 inhibitor |
|
|
What is the difference in celebrex and other NSAIDS?
|
have less GI side effects than other NSAIDS
|
|
|
What are some contraindications to using cox-2 inhibitors?
|
if allergic to ASA and NSAIDS, may also be allergic to cox-2 inhibitors
|
|
|
Who should be cautioned before taking cox-2 inhibitors?
|
pts w/ cardiovascular disease may increase their risk of MI
history of GI bleeds |
|
|
What are the side/adverse effects of cox-2 inhibitors?
|
diarrhea, abd. pain, GI bleed, risk of CVA/MI, renal impairment
|
|
|
What should you assess on a pt taking cox-2 inhibitors?
|
assess ROM, swelling and joint pain, GI bleed, edema, unexplained weight gain
|
|
|
What kind of drug is Tylenol (APAP)?
|
NSAIDS
|
|
|
What would the dosage be for a person taking regular APAP? extra strength? arthritis strength?
|
325 mg
500 mg 650 mg |
|
|
What is the toxic dose for APAP?
|
exceeding 4 g per day
(4000 mg) |
|
|
What would you use to treat a pt that has overdosed on APAP?
|
Acetylcysterine
|
|
|
What is APAP used for?
|
relief of mild-moderate pain and fever
has no anti-inflammatory effects |
|
|
Where is most of APAP metabolized?
|
liver
|
|
|
Who should use caution when taking APAP?
|
pts w/ liver disease
pts w/ chronic etoh use |
|
|
What should you assess for w/ a pt taking APAP?
|
pain: location, duration, intensity before and 30-60 min. after administration
OTC use amount and frequency use of etoh S/S of decreased blood counts, liver or renal failure CBC, LFTs, BUN, creatinine N/V, abd. pain decrease in fever |
|
|
Why are opioid analgesics controlled substances?
|
all have potential for physical/psychological dependence
|
|
|
What are opioids often used in combination with?
|
APAP, ASA, ibprofen
|
|
|
What kind of drug is morphine?
|
opioid analgesic
|
|
|
What is morphine used for?
|
relief of moderate to severe pain
preoperative sedation may also be used for severe diarrhea and cough |
|
|
Where is morphine metabolized?
|
liver
|
|
|
What are the contraindications for use w/ morphine?
|
allergy (rare)
|
|
|
What other drugs can morphine interact with?
|
additive effects w/ CNS depressants
|
|
|
What are the side/adverse effects opioid analgesics?
|
resp. depression and cough suppression
decreased BP, orthostatic hypotension, bradycardia skin flushing, itching, diaphoresis constipation, N/V urinary retention sedation, confusion, mood elevation, euphoria, restlessness, anxiety, depression, hallucinations |
|
|
What should you assess for on a pt before administering opioid analgesics>?
|
assess for etoh use
assess pain: character, duration, location and intensity before and after administration |
|
|
How long should you wait to assess a pt taking opioid analgesics po, subcut, or IM?
|
1 hr after administrating
|
|
|
How long should you wait to assess a pt taking opioid analgesics IV?
|
20-30 mins after administration
|
|
|
What should you monitor while a pt is on opioid analgesics?
|
vital sings
hold med if RR <12 check BP for hypotension check HR for bradycardia LOC urinary output bowel movements |
|
|
How should you prevent atelectsis w/ a pt taking opioid analgesics?
|
turn pt, make them cough, take deep breaths
|
|
|
How should you prevent constipation w/ a pt taking opioid analgesics for more than 2-3 days?
|
give stool softener
|
|
|
What is Narcan?
|
narcan is a opioid antagonist
|
|
|
What is narcan used for?
|
reversal of CNS and resp. depression due to opioid overdose
|
|
|
What should be cautioned when using narcan?
|
will cause immediate withdrawl symptoms in pts who are physically dependent (N/V, abd. cramps, HTN, increased temp, anxiety)
will reverse the analgeisa |
|
|
What are the side/adverse effects of narcan?
|
> or < BP, dysrhythmias, N/v
|
|
|
What is addiction?
|
compulsive use resulting in physical, psychological, or social harm to user and continued use despite that harm
|
|
|
What are the 4 c's of addiction?
|
craving
compulsive use control lost continued use despite harm |
|
|
What is tolerance?
|
a larger dose is needed to achieve pain relief
|
|
|
What is physical dependence?
|
the body becomes physiologically dependent upon the opioid so that withdrawal is experienced when the drug is no longer given
|
|
|
What are the s/s of physical dependence?
|
anxiety, chills, irritability, hot flashes, joint pain, sweating, vomiting
|
|
|
How can you prevent dependence on opioids?
|
by weaning the pts off the med.
|
|
|
What are immunosuppressants used for?
|
used in transplant pts to decrease incidence of transplant rejection
treat some inflammatory diseases |
