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25 Cards in this Set

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A/S - Pharamcologic Analgesia
A/S - pharmacologic Analgesia
What is preemptive use?
Administering drugs before or during surgery
If it is not possible to administer drugs before or during surg, when should they be administered?
Before pt wakes up
What are three methods for administering pharmacologic analgesia?
anagesic used as preanesthetic, epidural, local/regional nerve block
What is windup?
build up of chemical mediators in spinal cord that intensify the perception of pain
What is the mechanism of action for pharmacologic analgesia?
prevents windup
Does preemptive analgesia remove the need for addtl post op pain control?
No
NSAIDs work at the ___ level
tissue, some have direct effect in brain
What analgesics block xmission of pain impulses in sensory nerves?
local anesthetics
What analgesics affect sites in brain and spinal cord to decrease perception of pain?
Opioids
What is the term for using drugs from more than one class of analgesic to give more effective pain relief, decr amt of each drug, and decr side effects?
Balancedor multimodal analgesia
What are three classes of pharacologic analgesics?
Opioids, NSAIDs, Local anesthetics
What class of pharmacologic analgesic is used as a preanesthetic, produces neuroleptanalgesia, and postoperative pain control
opioids
What opioid is both an agonist and an antagonist?
Butorphanol
What are some off label routes of admin for opioids? Why used?
IV infusion, epidurals, dermal patches, intra-articular - longer duration than IM or SC, less potential for side effects
What drug reverses opioids?
Nalaxone
All NSAIDs are effective analgesics for ___ pain
somatic
Older NSAIDs are not effective for ___ pain
analgesic
All NSAIDs req ___ minutes to take effect
30-60
All NSAIDs have significant side effects which may increase surgical risks - name them (3)
decr platelet aggregation, decr renal blood flow, metabolized by liver and excreted by kidney or bile
Should NSAIDs be used preemptively?
Better not to - if you have to, give IV fluids
NSAIDs can cause ulcers - given this, what precautions should be taken?
Use carprofen, etodolac, or meloxicam (less ulcerogenic), give w/ meal, use GI protectants such as sucralfate
What are some advantages of NSAIDs over opoids?
oral, not controlled, littel resp/cardiac effect, no sedative effect (for postoperative use)
What are some contraindications for NSAIDs?
Tylenol in cats (use ketoprofen), dehydrated/hypotensive pt. liver or kidney dysfunction, corticosteroids, GI disorders, CHF, clotting disorders
What class of pharmacologic analgesics are used pre-emptively only?
local anesthetics