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