Pharm 3- Pain
Card Set Information
Pharm 3- Pain
Anesthesia & Analgesics
General actions (SE) of opioids (slide on p. 5)
***watch for hypotension!!!** (decreased preload & afterload)
Most common SE of opioids.
Most SERIOUS ADR of opioids. (slide 29)
S/S of opioid OD.
cold clammy skin
pinpoint pupils (miosis)
decreased HR, BP, RR
Dilaudid has a ______ onset but shorter ______ of morphine and is 7-10 times _____ effective than morphine.
*high abuse potental
Hydrocodone is often combined with ______ or _______. Considerations?
acetaminophen (Vicodin) *non anti-inflammatory
aspirin (Lortab-ASA) *anti-inflammatory
*risk of liver toxicity
Meperidine (Demerol) axn is _____ than morphine.
shorter (more frequent dosing)
If a pt comes in with pain from GI problems, what med is given and why?
does not increase biliary tract pressure
If a pt comes in with pain from acute asthma, what med is given and why?
less likely to produce histamine release
Problems with Demerol?
Neurotoxicity with sickle cell, burn injuries, cancer
Severe/fatal rxn with MAOIs
resp depression in COPD pts
not good for elderly
Common SE of Methadone that can last several weeks.
Nursing considerations with Fentanyl?
clean, hairless site
take old patch off b4 applying new one
"waste" it b/c it's a C/S -do not just throw in trash
Cautions with butorphanol (Stadol).
-MI (increases wrkld)
may increase CSF (monitor ICP)
Caution with pentazocine (Talwin).
Use for nalbuphine (Nubain).
-preop as adjuct to anesthesia
-L&D (obstetric analgesia)
Reversal agent for opioid OD.
*contraindicated in acute hepatitis*
Cox-2 receptors are mainly at the _______ but also in the _____ and _____
site of injury (mediate local inflammation, sensitize pain)
brain (fever & pain perception)
kidney (renal vasodilation)
Inhibiting Cox-2 receptors results in?
renal impairment possible
Advantage of Cox-2 inhibitors over Cox-1?
reduced GI effects
(but no advantages r/t CAD or CVA risk)
Anesthetic used for young children undergoing minor surgical & diagnostic procedures; problems during recovery?
Dissociative anesthetic - ketamine (Ketalar)
-hallucinations, disturbing dreams, delerium
Nursing considerations for pts recovering after receiving ketamine (Ketalar).
keep lights down
tell them what you're doing