Term
| Morphine Sulfate is what type of analgesic? |
|
Definition
|
|
Term
| meperidine HCL (Demerol) side effects... |
|
Definition
Be careful when using Demerol potential side effect is seizure due to accumulation of neural metabolite.
BIGGEST SIDE EFFECT: CNS Depression (drowsy, decreased HR and breathing), resulting in Respiratory Depression. Also, Constipation, Urinary retention, Itching, rash. |
|
|
Term
| naloxone (Narcan) is what? |
|
Definition
| An Antidote for opiods. Given IV, IM, and SQ. REMEMBER THAT REDOSING MAY BE NEEDED b/c half life of narcan is much less than opioid. |
|
|
Term
| Opioid analgesics Mechanism of Action and Drug Effects |
|
Definition
Act in the CNS to reduce pain.
Agonists- binds to an opioid pain receptor in the brain and causes an analgesic response
Partial agonist- binds to a pain receptor but causes a weaker neurologic response than a full agonist
Antagonist-binds to the pain receptor but does not reduce pain signals, competes with agonist and partial agonist drugs at the receptor sites |
|
|
Term
| Indications of Opioid Analgesics |
|
Definition
|
|
Term
| What is the difference between psychologic dependence and physical dependence? |
|
Definition
Psychologic Dependence- (Addiction) primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. Addiction is characterized by behaviors that include: impaired control over drug use, compulsive use, continued use despite harm, and craving
Physical Dependence- state of physiologic adaptation that is manifested by a drug-class-specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and administration of an antagonist
|
|
|
Term
Choose the correct answer Constipation is: a. an old british warship b. a formation of stars c. a side effect of opioid use d. what you may be feeling right now |
|
Definition
| c. A side effect of opioid use |
|
|
Term
|
Definition
| Post-operative pain and severe pain. Often induced by boring lectures. |
|
|
Term
| Common side effects of opiod use |
|
Definition
Common side effects are histamine release, CNS depression, GI tract issues, and urinary retention. Also see table 10-6 in book |
|
|
Term
| CNS depression can lead to what? |
|
Definition
|
|
Term
| Describe opioid tolerance |
|
Definition
is a state of adaptation in which exposure to a drug induces
changes that result in a diminution of one or more of the drug’s effects over time. Leads to progressively higher dosages to maintain the same analgesic effect
|
|
|
Term
| Why should meperidine use be restricted (Demerol, Pethidine) |
|
Definition
| Because of the unpredictable effects of neurometabolites at analgesic doses and risk for seizures. |
|
|
Term
| What happens when you take opioids with other CNS depressants? |
|
Definition
| It can result in additive respiratory depressant effects |
|
|
Term
| acetaminophen (Tylenol) is what type of drug? |
|
Definition
Nonopioid Analgesics (Nonnarcotics) provides mild to moderate pain relief |
|
|
Term
| Acetaminophen inhibits prostaglandin synthesis. What does that mean? |
|
Definition
| Blocks peripheral pain impulses |
|
|
Term
| Tylenol is both an analgesic and ? |
|
Definition
|
|
Term
| What does antipyretic mean? |
|
Definition
| Reduces body temperature by action on the hypothalamus |
|
|
Term
| Side effects of Acetaminophen |
|
Definition
Acetaminophen is relatively safe when taken as directed.
**Acute overdose can cause hepatic necrosis (liver)
**Long-term ingestion of large doses can cause nephropathy (kidneys affected)
|
|
|
Term
| What is the standard maximum daily dose for healthy adults? |
|
Definition
|
|
Term
What is the recommended antidote for acetaminophen toxicity? How many doses must be given?
|
|
Definition
Acetylcysteine- prevents hepatotoxic metabolites of acetaminophen from forming
Initial loading dose: 140mg/kg orally (smells like rotten eggs)
Followed: 70mg/kg every 4 hours for 17 additional doses
If vomiting occurs within 1 hour give the initial dose again, all 17 doses must be given to prevent hepatotoxicity
|
|
|
Term
| Interactions with acetaminophen |
|
Definition
Alcohol is potentially the most dangerous. Why is that?
Increased liver toxicity from excess acetaminophen use
Liver dysfunction and failure |
|
|
Term
| Be familiar with equianalgesic doses of opioids (Table 10-8). Lack of knowledge can lead to inadequate pain control. If you had been giving 10mg of morphine IM, how much would you give PO? |
|
Definition
Equianalgesic Dose (mg)
Opioid Analgesic Intramuscular Oral
Codeine 130 75
Hydromorphone 1.5 7.5
Meperidine 75 300
Methadone 10 20
Morphine 10 (standard) 30 (standard)
Oxycodone Injection not available 30
Oxymorphone 110 (rectal)
Note: Fentanyl is most commonly given intravenously, transdermally (patch), or orally (lollipop).
|
|
|
Term
| What does NSAID stand for? |
|
Definition
| nonsteroidal anti-inflammatory drugs. They have analgesic, anti-inflammatory, antirheumatic, and antipyretic activity. |
|
|
Term
| What are some symptoms of the activation of the arachidonic acid pathway? |
|
Definition
| Pain, headache, fever, and inflammation |
|
|
Term
| What do prostoglandins do? |
|
Definition
| They transmit pain, increase blood flow to kidneys, protect the lining of stomach, dilate small vessels leading to inflammation. |
|
|
Term
| Antiinflammatory Agents (NSAIDS) such as celecoxib (Celebrex) is what? |
|
Definition
|
|
Term
Antiinflammatory Agents (NSAIDS):
Primary function is |
|
Definition
to treat arthritis.
Side effects:
GI Distress (ulceration, bleeding)
Renal Failure
Bleeding
**on test** Patient Teaching. Take NSAIDs with food, milk, or an antacid to prevent GI irritation. |
|
|
Term
| Mechanism of Action and Drug Effects for NSAIDS |
|
Definition
Inhibits the arachidonic acid pathways.
NSAID’s relieve pain, headache, and inflammation by blocking the chemical activity of either or both of the enzymes COX (PG pathway) and leukotriene (LT pathway). |
|
|
Term
| Generally, the side effects of NSAIDS are? |
|
Definition
|
|
Term
| Antiinflammatory Agents (Antigout): colchicine**Key drug for test* |
|
Definition
| reduces inflammatory response, but does nothing for the excretion of uric acid. |
|
|
Term
Anti-gout Mechanism of Action and Drug Effects
Reduce the inflammatory response to what? |
|
Definition
Reduces the inflammatory response to the deposits of urate crystals in joint tissue.
Inhitits polymorphonuclear leukocyte metabolism, mobility, and chemotaxis |
|
|
Term
|
Definition
|
|
Term
**Side Effects and Adverse Effects of anti-gout meds
|
|
Definition
Short-term leukopenia – inhibits cell mitosis
Bleeding – GI and urinary tracts
Renal failure
|
|
|
Term
| Antiinflammatory Agents (Antirheumatoid): sulfasalazine (Azulfidine)**key drug for test** |
|
Definition
a DMARD that prevents the progression of rheumatoid arthritis. Rheumatoid is systemic, chronic, destructive and w/autoimmune component.
Ostoarthritis - unilateral, bones...
|
|
|
Term
Mechanism of Action and Drug Effects of Antirheumatoid meds... |
|
Definition
| Inhibit the movement of various cells into inflamed joints |
|
|
Term
|
Definition
*It is important to know that these drugs are referred to as disease-modifying antirheumatic drugs (DMARDs) – they actually prevent the progression of the disease.
|
|
|
Term
| Nursing Process/Teaching Tips/Points to Remember for antiinflammatory agents |
|
Definition
| Encourage patients to take NSAIDs with food, milk, or an antacid to prevent/decrease GI irritation. |
|
|
Term
| Difference between nonsteroidal anti-inflammatory dugs and opioids: |
|
Definition
| Unlike opioids, effectiveness is limited by a ceiling effect in that any further increase in the dose beyond a certain level increase the risk for adverse effects without a corresponding increase in the therapeutic effect. In contract, opioid doses may be titrated almost indefinitely to increasingly higher levels |
|
|
