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