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38 Cards in this Set
- Front
- Back
A brand name of codeine is?
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Paveral
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Therapeutic classification of codeine is? (5)
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allergy
cold cough remedies antitussives opioid analgesics |
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Pharmacologic classification of codeine is?
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opioid agonists
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Indication of codeine is?
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Management of mild to
moderate pain Antitussive in smaller doses Unlabeled uses: management of diarrhea |
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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 ____ ______? |
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Therapeutic effects of codeine are?
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decreased severity of pain
suppression of cough reflex relief of diarrhea |
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Use codeine with extreme caution in patients receiving _____ _______ (reduce initial dosage to 25% of usual dose)
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MAO inhibitors
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Assess what 3 things before and periodically during administration?
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blood pressure
pulse respiration |
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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% |
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Assess bowel function routinely. Prevention of ______ should be instituted with increased (3) things
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constipation
intake of fluids intake of bulk laxatives |
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Stimulant laxatives should be administered routinely if opioid use exceeds how much?
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2-3 days
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What should nurse assess about pain and at what peak time after administration?
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type
location frequency 1 hour |
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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.
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25-50%
50% |
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What kind of chart should be used when changing routes or when changing from one opioid to another?
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equianalgesic chart
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Prolonged use may lead to? (3)
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physical dependence
psychhological dependence tolerance |
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Most patients who receive codeine for pain do not develop?
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psychological dependence
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If progressively higher doses are required, consider conversion to a?
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stronger opioid
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During antitussive use, nurse should assess?
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cough
lung sounds |
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Lab test considerations...may cause?
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increased plasma amylase
increased lipase concentrations |
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If an opioid antagonist is required to reverse respiratory depression or coma, what is the antidote?
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naloxone (Narcan)
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Accidental overdosage of opioid analgesics has resulted in?
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fatalities
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Before administering codeine,
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have second practitioner independently check dose calculations, route of administration, and infusion pump programming
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Regularly administered doses may be more effective than ____ administration.
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prn
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Analgesic is more effective if given before pain becomes?
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severe
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Medications should be discontinued?
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gradually after long-term use to prevent withdrawal symptoms
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Combine codeine with nonopioid analgesics (such as aspirin or acetaminophen)
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#2 = 15 mg
#3 = 30 mg #4 = 60 mg codeine |
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Codeine as an individual drug is a Schedule?
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II substance
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Codeine in combination with other drugs, tablet form is Schedule?
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III
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In combination with other drugs, liquid form is Schedule?
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IV
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In combination with other drugs, elixir or cough suppressant is Schedule?
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V
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PO may be administered with?
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food or milk to minimize GI irritation
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With IM or subcutaneous, do not administer solution that is more than slightly?
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discolored or contains a precipitate
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Codeine is usually administered?
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IM or subcutaneous...slow IV has been used
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Patient should call for assistance when?
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smoking
ambulating |
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Change positions slowly to avoid?
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hypotension
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Encourage patient to turn, cough, and breathe deeply every 2 hrs to prevent?
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atelectasis
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Advise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease?
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dry mouth
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Effectiveness of therapy can be demonstrated by?
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decrease in severity of pain
without a signficant alteration in level of consciousness or respiratory status suppression of cough control of diarrhea |