Drug facts for pain meds

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Drug facts for pain meds
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2012-07-07 09:25:34
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Drug facts for pain meds butterbug10
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  1. Key facts about nonopiod analgesics [Ex: aspirin (ASA), acetaminophen (Tempra, Tylenol), fenoprofen calcium (Nalfon), ibuprofen, naproxen (Advil, Motrin), ketotolac tromethamine (Toradol), naproxen (Naprosyn), celecoxib (Cerebex)]
    • Act peripherally to prevent prostaglandin formation in inflamed tissues by two actions
    • 1. inhibit stimulation of pain receptors
    • 2. inhibit prostaglandin synthesis in the CNS and stimulate peripheral vasodilation to reduce fever
    • Metabolized in the liver
    • Excreted in urine, breast milk, and feces
  2. When to use nonopiod analgesics [Ex: aspirin (ASA), acetaminphen (Tempra, Tylenol), fenoprogen calcium (Nalfon), ibuprofen, naproxen (Advil, Motrin), ketotolac tromethamine (Toradol), naproxen (Naprosyn), celecoxib (Cerebex)]
    • Pain
    • Arthritis and osteoarthritis
    • Fever reduction
    • Inflammation reduction
    • Prevention of transient ischemic attacks and MI
    • Dysmenorrhea
  3. When NOT to use nonopiod analgesics [Ex: aspirin (ASA), acetaminophen (Tempra, Tylenol), fenoprogen calcium (Nalfon), ibuprofen, naproxen (Advil, Motrin), ketotolac tromethamine (Toradol), naproxen (Naprosyn), celecoxib (Cerebex)]
    • Aspirin hypersensitivity
    • Bleedign disorders
    • Pregnancy
    • Heart disease of sulfa allergy (celecoxib)
  4. Adverse reactions to nonopiod analgesics [Ex: aspirin (ASA), acetaminophen (Tempra, Tylenol), fenoprogen calcium (Nalfon), ibuprofen, naproxen (Advil, Motrin), ketotolac tromethamine (Toradol), celecoxib (Cerebex)]
    GI pain and upset, nausea, vomiting, diarrhea, heartburn, dizziness, h/a, tinnitus, rash, severe throbotic events, ulcers
  5. Key nursing actions for nonopiod alagesics [Ex: aspirin (ASA), acetaminophen (Tempra, Tylenol), fenoprogen calcium (Nalfon), ibuprofen, naproxen (Advil, Motrin), ketotolac tromethamine (Toradol), celecoxib (Cerebex)]
    • Administer the drug before meals for a rapid effect and wiht meals for GI urrutation reduction
    • Advise the pt that the CDC warns against giving salicylates to children or adolescents with influenza, varicella, or viral illness
    • Closely monitor the pt taking a COX-2 drug for thromboembolitic events
  6. Key facts about opiod agonists and mixed agonists-antagonists [Ex: opioid: codeine, fentayl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin); mixed: buprenorphine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine (Talwin)]
    • Bind to opiate receptors n the CNS to alter the perception of and emotional response to pain
    • Metabolized in liver
    • Excreted in urine
  7. When to use opioid agonists and mixed agonists-antagonists [Ex:opioid: codeine, fentanyl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin); mixed: buprenorphine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine (Talwin)]
    • Adjuncts to anethesia
    • Cough relief
    • Pain due to MI or pulmonary edema
    • Pain unresponsive to nonopiod analgesics
  8. When NOT to use opiod agonists and mixed agonists-antagonists [Ex: opioid: codeine, fentanyl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin); mixed: buprenorphine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine (Talwin)]
    Hx of opiod abuse
  9. Adverse reactions to opioid agonists and mixed agonists-antagonists [Ex: opioid: codeine, fentanyl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin); mixed: buprenorphine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine (Talwin)]
    • Orthostatic hypotension, sedation, constipation, respiratory depression, psychological deprendence, pupil constriction
    • Neurotoxicity, seizures (meperidine)
  10. Key nursing actions for opioid agonists and mixed agonists-antagonists [Ex: opioid: codeine, fentanyl (Duragesic), hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin); mixed: buprenorphine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine (Talwin)]
    • Assess the pt's blood pressure, pulse, and respiratory status beofre administering the drug and periodically throughout analgesic therapy
    • Prolonged use of an opioid analgesic or opioid agonist-antagonist may cause dependence and tolerance, but shouldn't preclude administration of adequate administration of adequate analgesia
    • Know that naloxone is the antidote for opioid overdose
  11. Topics for discussion for opioid agonists and mixed agonists-antagonists [Ex: opioid: codeine, fentanyl (Duragesic), hyrodmorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin); mixed: buprenorphine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine Talwin)]
    • Medication prescribed
    • Administration instructions
    • Signs and symptoms, including adverse reactions
  12. Key facts about opioid antagonists [Ex" Nalmefene (Revex), naloxone (Narcan), naltrexone (ReVia)]
    • Competitively block the effects of opioids without producing analgesic effects
    • Metabolized in liver
    • Excreted in urine
  13. When to use opioid antagonists [Ex: namefene (Revex), naloxone (Narcan), naltrexone (ReVia)]
    • opioid overdose
    • Adjunct to therapy in treating drug abuse
  14. When NOT to use opioid antagonists [Ex: namefene (Revex), naloxone (Narcan), naltrexone (ReVia)]
    Use cautiously in pts physically dependent on opioids
  15. Adverse reactions to opioid antagonists [Ex: namefene (Revex), naloxone (Narcan), naltrexone (ReVia)]
    Nausea, vomiting, tachycardia, hypotension, hypertension, arrhythmias, hyperventilations, tremors
  16. Key nursing actions for opioid antagonists [Ex: namefene (Revex), naloxone (Narcan), naltrexone (ReVia)]
    • Assess respiratory status, BP, pulse, and LOC until the opioid wears off
    • Opioid antagonist dosage should be adjusted according to the pt's pain level
    • Give only the amt required to reverse respiratory depression or increase mental alertness
  17. Key facts about rapid-acting hypnotics [Ex: methohexital, medazolam hydrochloride (Versed), propofol (Diprivan), thiopental sodium (Pentothal)]
    • Stabilize neuronal membranes to produce frogressive, reversible CNS depression
    • Metabolized in the liver
    • Excreted renally or hepatically
  18. When to use rapid-acting hypnotics [Ex: methohexital, medazolam hydrochloride (Versed), propofol (Diprivan), thiopental sodium (Pentothal)]
    • Anesthesia induction and maintenance
    • Anesthesia extension
  19. Topics for patient discussion for rapid-acting hypnotics [Ex: methohexital, medazolam hydrochloride (Versed), propofol (Diprivan), thiopental sodium (Pentothal)]
    • Type of anesthetic prescribed
    • Possible psychomotor function impairment
    • Sign and symptoms, including adverse reactions
  20. Adverse reactions to rapid-acting hypnotics [Ex: methohexital, medazolam hydrochloride (Versed), propofol (Diprivan), thiopental sodium (Pentothal)]
    Respiratory depression, apnea, hypotension, tachycardia, nausea and vomiting, muscle twitching, tissue necrosis with extravasation
  21. Key nursing actions for rapid-acting hypnotics [Ex: methohexital, medazolam hydrochloride (Versed), propofol (Diprivan), thiopental sodium (Pentothal)]
    • Determine if the pt has allergies before the surgery
    • Assess cardiovascular, respiratory, and renal status and LOC before and after surgery
  22. Key facts about inhalation anesthetics [Ex: desflurane (Suprane), enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), nitous oxide]
    • Depress the CNS
    • Metabolized in lungs and liver
    • Excreted in urine
  23. When to use inhalation anesthetics [Ex: desflurane (Suprane), enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), nitrous oxide]
    • Promotion of loss of consciousness, loss of responsiveness to sensory stimulation including pain and muscle relaxation
    • Anesthesia maintenance
  24. When NOT to use inhalation anesthetics [Ex: desflurane (Suprane), enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), nitrous oxide]
    Hypersensitivity, liver disorders, hx of malignant hyperthermia
  25. Adverse reactions to inhalation anesthetics [Ex: desflurane (Suprane), enflurane (Ethrane), halothane (Fluothane), isoflurane (Florane), nirtous oxide]
    Exaggerated response to the normal dose (most commone0, postanesthesia nausea and vomiting, hypotension, arrhythmias, tachycardia, confusion, agitation, memory loss
  26. Key nursing actions for inhalation anesthetics [Ex: desflurane (Suprane), enflurane (Ethrane), halothane (Fluothane), isoflurane (Florane), nitrous oxide]
    • Keep atropine available at all times to reverse possible bradycardia
    • Monitor the pt's temperature frequently
    • Shivering is normal during recovery; if shivering occurs, keep the pt warm with extra blankets or heat and administer O2, as prescribed, to compensate for the increased oxygen demand
  27. Key facts about injectable analgesic anesthetics [Ex: alfentanil (Alfenta), etomidate, remifentanil (Ultiva), sufentanil (Sufenta)]
    • Depress the CNS
    • Metabolized by the liver
    • Excreted in feces
  28. When to use injectable analgesics [Ex: alfentanil (Alfenta), etomidate, remifentanil (Ultiva), sufentanil (Sulfenta)]
    • Rapid anesthesia or moderate sedation inducation
    • Pain
  29. When NOT to use injectable analgesic anesthetics [Ex: alfentanil (Alfenta), etomidate, remifentanil (Sulfenta)]
    Hypersensitivity
  30. Adverse reactions to use injectable analgesic anesthetics [Ex: alfentanil (Alfenta), etomidate, remifentanil (Sulfenta)]
    Respiratory depression, arrhythmias, bradycardia, skeletal and thoracic muscle regidity, seizures, asystole, dry mouth, urine retention shivering
  31. Key nursing actions for injectable anagesic anesthetics [Ex: alfentanil (Alfenta), etomidate, remifentanil (Sulfenta)]
    • Continuously assess repiratory status
    • Only those experienced in endotracheal intubation should use these drugs
  32. Key facts about neuroleptanesthetics [Ex:droperidol (Inapsine), ketamine (Ketalar)]
    • Produce dissociation from the environment during induction of anesthesia
    • Metabolized in liver
    • Excreted in feces
  33. When to use neuroleptanesthetics [Ex: droperidol (Inapsine), ketamine (Ketalar)]
    Analgesia induction
  34. When NOT to use neuroleptanesthetics [Ex: droperidol (Inapsine), ketamine (Ketalar)]
    • Hypertension
    • Cardiac decompensation
    • HX of stroke
    • Surgery of the pharynx, larynx, or bronchial tree
  35. Adverse reactions to neuroleptanesthetics [Ex: droperidol (Inapsine), ketamine (Ketalar)]
    Hallucinations, seizures, shivering, extrapyramidal signs and symptoms, QT interval prolongation, torsade de pointes
  36. Key nursing actions for neuroleptics [Ex: droperidol (Inapsine), ketamine (Ketalar)]
    • Monitor vital signs and cardio-pulmonary status
    • Minimize environmental stimulation
  37. Key facts about local anesthetics [Ex: benzocaine (Dermoplast), chloroprocaine hydrochloride (Nesacaine), cocaine hydrochloride, dibucaine (Nupercainal), lidocaine hydrochloride (Xylocaine Hydrochloride), procaine hydrochloride (Novocain)]
    • Provide analgesic relief by blocking the conduction of nerve impulses at the point of contact
    • Metabolism varies
    • Excreted in urine
  38. When to use local anesthetics [Ex: benzocaine (Dermoplast), chloroprocaine hydrochloride (Nesacaine), cocaine hydrochloride, dibucaise (Nupercainal), lidocaine hydrochloride (Xylocaine Hydrochloride), procaine hydrochloride (Novocaine)]
    • Pain
    • Anesthesia, including spinal and epidural
  39. When NOT to use local anesthetics [Ex: benzocaine (Dermoplast), chloroprocaine hydrochloride (Nesacaine), cocaine hydrochloride, dibucaise (Nupercainal), lidocaine hydrochloride (Xylocaine Hydrochloride), procaine hydrochloride (Novocaine)] 
    • Drug hypersensitivity
    • Myasthenia gravis
    • Severe shock
    • Impaired cardiac conduction
  40. Adverse reactions to local anesthetics [Ex: benzocaine (Dermoplast0, chloroprocaine hydrochloride (Nesacaine), cocaine hydrochloride, dibucaise (Nupercainal), lidocaine hydrochloride (Xylocaine Hydrochloride), procaine hydrochloride (Novocaine)]
    Anxiety, restless, arrhythmias, bradycardia, hypotension, chills
  41. Key Nursing Actions for local anesthetics [Ex: benzocaine (Dermoplast), chloroprocaine hydrochloride (Nesacaine), cocaine hydrochloride, dibucaise (Nupercainal), lidocaine hydrochloride (Xylocaine Hydrochloride), procaine hydrochloride (Novocaine)]
    • Assess for return of motor function and sensation postoperatively
    • Ensure that the gag reflex has returned before feeding a patient whose throat has been anesthetized
  42. Key facts about topical anesthetics [Ex: benzocaine, benzyl alcohol, butacaine, butamben, dyclonine, ethyl chloride, lidocaine, menthol, procaine, tetracaine]
    • Block nerve impulse transmission
    • Stimulate the nerve endings and interfere with pain perception
    • Stimulate the cold sensation resceptors and block the nerve endings in the frozen area
    • Metabolized in blood and liver
    • Excreted in urine
  43. When to use topical anesthetics [Ex: benzocaine, benzyl alcohol, butacaine, butamben, dyclonine, ethyl chloride, lidocaine, menthol, procaine, tetracaine]
    • Pain
    • Anesthesia
    • Surface numbing
  44. When NOT to use topical anesthetics [Ex: benzocaine, benzyl alcohol, butacaine, butamben, dyclonine, butamben, dyclonine, ethyl chloride, lidocaine, menthol, procaine, tetracaine]
    Drug hypersensitivity
  45. Adverse reactions to topical anesthetics [Ex: benzocaine, benzyl alcohol, butacaine, butamben, dyclonine, ethyl chloride, lidocaine, menthol, procaine, tetracaine]
    Hypersensitivity
  46. Key nursing actions for topical anesthetics [Ex: benzocaine, benzyl alcohol, butacaine, butamben, dyclonine, ethyl chloride, lidocaine, menthol, procaine, tetracaine]
    • Assess the area where topical anesthetic is to be applied before during, and after application
    • Don't apply a refrigerated topical anesthetic to be broken skin or mucous membranes

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