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38 Cards in this Set

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  • Back
A brand name of codeine is?
Paveral
Therapeutic classification of codeine is? (5)
allergy
cold
cough remedies
antitussives
opioid analgesics
Pharmacologic classification of codeine is?
opioid agonists
Indication of codeine is?
Management of mild to
moderate pain
Antitussive in smaller doses

Unlabeled uses:
management of diarrhea
MOA of codeine is?
Binds to ______ receptors in CNS?

CNS depression...decreases cough reflex and GI motility
opiate...alters perception of and response to painful stimuli while producing
generalized ____ ______?
Therapeutic effects of codeine are?
decreased severity of pain
suppression of cough reflex
relief of diarrhea
Use codeine with extreme caution in patients receiving _____ _______ (reduce initial dosage to 25% of usual dose)
MAO inhibitors
Assess what 3 things before and periodically during administration?
blood pressure
pulse
respiration
If respiratory rate is less than ____, assess level of sedation. Physical stimulation may be sufficient to prevent significant _______.
Dose may need to be decreased by how much? Initial drowsiness will diminish with continued use.
10/min

hypotension

25-50%
Assess bowel function routinely. Prevention of ______ should be instituted with increased (3) things
constipation

intake of fluids
intake of bulk
laxatives
Stimulant laxatives should be administered routinely if opioid use exceeds how much?
2-3 days
What should nurse assess about pain and at what peak time after administration?
type
location
frequency

1 hour
When titrating opioid doses, increases of _____ should be administered until there is either a ___ reduction in patient's pain rating on a numerical or visual analog scale or patient reports satisfactory pain relief.
25-50%

50%
What kind of chart should be used when changing routes or when changing from one opioid to another?
equianalgesic chart
Prolonged use may lead to? (3)
physical dependence
psychhological dependence
tolerance
Most patients who receive codeine for pain do not develop?
psychological dependence
If progressively higher doses are required, consider conversion to a?
stronger opioid
During antitussive use, nurse should assess?
cough
lung sounds
Lab test considerations...may cause?
increased plasma amylase
increased lipase
concentrations
If an opioid antagonist is required to reverse respiratory depression or coma, what is the antidote?
naloxone (Narcan)
Accidental overdosage of opioid analgesics has resulted in?
fatalities
Before administering codeine,
have second practitioner independently check dose calculations, route of administration, and infusion pump programming
Regularly administered doses may be more effective than ____ administration.
prn
Analgesic is more effective if given before pain becomes?
severe
Medications should be discontinued?
gradually after long-term use to prevent withdrawal symptoms
Combine codeine with nonopioid analgesics (such as aspirin or acetaminophen)
#2 = 15 mg
#3 = 30 mg
#4 = 60 mg codeine
Codeine as an individual drug is a Schedule?
II substance
Codeine in combination with other drugs, tablet form is Schedule?
III
In combination with other drugs, liquid form is Schedule?
IV
In combination with other drugs, elixir or cough suppressant is Schedule?
V
PO may be administered with?
food or milk to minimize GI irritation
With IM or subcutaneous, do not administer solution that is more than slightly?
discolored or contains a precipitate
Codeine is usually administered?
IM or subcutaneous...slow IV has been used
Patient should call for assistance when?
smoking
ambulating
Change positions slowly to avoid?
hypotension
Encourage patient to turn, cough, and breathe deeply every 2 hrs to prevent?
atelectasis
Advise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease?
dry mouth
Effectiveness of therapy can be demonstrated by?
decrease in severity of pain
without a signficant
alteration in level of
consciousness or respiratory
status
suppression of cough
control of diarrhea