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30 Cards in this Set
- Front
- Back
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NSAIDS
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Ibuprophen (Motrin)
Naproxen (Aleve) Ketorolac (Toradol) Sulindac (Clinoril) Nambumetone (Relafen) Indomethacin (Iodocin) Piroxican (Feldene) Tolmetrin (Tolectin) Meclofenamate (Meclomen) Selective cox-2 inhibitor Celecoxib (Celebrex) |
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Tell me about Step 1 on the Analgesic Ladder
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Step 1
Mild Pain Non-opioid analgesic Aspirin, acetaminophen, NSAIDS |
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NSAIDS are contraindicated when...
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Peptic ulcer
Bleeding Renal Impairment Selective in cardiovascular diesease And they have a "ceiling effect" |
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Tell me about Step 2 on the Analgesic Ladder.
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Step 2
Moderate Pain Low dose opioid may combine with non-opioid Acetaminophen combinations- codeine, propoxyphene, morphine |
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What are they Acetaminophen Combinations?
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Acetaminophen + Codeine (Tylenol #3, Tylenol #4)
Acetaminophen + oxycodone (Percocet) Acetaminophen + hydrocodone (Lortab, Vicoden, Norco) |
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What must you watch when giving Acetaminophen combinations?
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Acetaminophen OD
Respiratory depression Constipation Increased risk of peptic ulcers Keep Acetaminophen under 4g/day |
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Tell me about Step 3 on the Analgesic Ladder.
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Step 3
For severe pain (episodic or continuous |
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What drugs are considered Step 3?
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Narcotics
Morphine Oxycodone (Roxicodone, Oxycotin) Hydromorphone (Dilaudid) Fentanyl (Duragesic) Methadone Meperidine (Demerol) |
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Morphine
What is the Onset, Duration, Dose, Adverse effects, and Interactions? |
Onset- IV (fastest) IM, SQ, PO
Duration Dose Adverse effects -respiratory depression -dependence -constipation -flushing, pruitis -Stimulates ADH release Interactions |
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Hydromorphone (Dilaudid)
What is the route and adverse side effects? |
Route: IV, PO,rectal, SQ, IM
Adverse: -constipation -hypotension -confusion |
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Fentanyl (2 brand names)
What is the route and Adverse effects? |
Sublimaze and Duragesic
Route: -Oral,Parental, Transdermal Adverse effects: -apnea -constipation -n and v -sedation |
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What is a Narcotic Antagonist?
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This drug will turn a narcotic off.
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Name a Narcotic Antagonist.
What is its action, use, onset, duration, caution, 1/2 life? |
Naloxone (Narcan)
action: blocks effects of opioids use:IV, IM, SQ onset: immediate duration: caution: watch for resedation 1/2 life: 60-90 min |
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What is an Adjuvant?
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A drug that enhance the effect of opioids and or decrease the side effects of opioids.
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Name 4 Adjuvants.
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Anti depressants
Anti convulsants Corticosteroids Antihistamines |
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Antidepressants
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Tricyclics: nortirptyline (Pamelor)
Atypicals: bupropion (Welburtin), duloxetine (Cymbalta) SSRIs: fluoxetine (Prozac), sertraline (Zoloft) |
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Anti convulsants
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Gabapentin (Neurontin)
Pregabalin (Lyrica) |
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Corticosteroids
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Prednisone
Dexamethasone (Decadron) |
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Antihistamines
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Hydroxyzine (Vistaril)
Promethazine (Phenergan) Diphenhydramine (Benadryl) |
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When giving a pt and IV when do you reasess?
When do you reasses for PO meds? |
IV 15-30 min
PO 45-60 min |
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Name some Non- Pharmacologic approaches to pain management.
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Aromatherapy, music, imagery, relaxation, distraction, acupuncture, hypnosis, biofeedback, therapeutic touch, massage
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What is the "Gate control therory"?
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that to much stimulase shuts the gate in the spinal cord and the impulses cannot reach the brain.
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What are the chemical in the body that inhibit pain?
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endorphins and eukephalins
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What is Nociecptive pain?
What are the 3 kinds? |
It is a painful stimuli
Cutaneous: Skin Somatic: tendons, bones Visceral: organs |
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What is Neuropathic pain?
What are the 2 kinds? |
It is pain associated with disfunction in the Nervous system
Allodynia: peripheral, central nerve pain Phantom limb pain: nerves are injured |
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What is Psychogenic pain?
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Physical pain that is caused by increased or prolonged mental, emotional, or behavorial factors.
Exp: headache, backpain, stomach pain |
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What is Referred Pain?
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an area that is hurting where the pain did not originate from.
exp: heart attach/pain in jaw |
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Acute Pain lasts for...
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Six months or less
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Chronic Pain lasts for...
What are 2 types of chronic pains? |
Six months or more
Persistant and Intermittent |
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What is the physiologic response to Acute Pain
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Stress response:
Increased HR, BP, RR Dilated pupils Pallor or flushing Increased BS Increased gastric acid secretion Psychological response: crying, yellling, screaming |
