Analgesia

Question 1

barbiturates and benzodiazepines

Answer 1

Are CNS depressants BUT Don’t have the severe effects narcotics do

Question 2

Tramodol

Answer 2

Combo of opioid and non opioid actions To control pain

Low potential for increase dependence or respiratory depression

Mild effect on Mu Receptors BUT also blocks the reuptake of norepinephrine and serotonin in the brain

Question 3

How do opioids affect pain

Answer 3

don’t get ride of the cause of pain but block the reception or pain in the central nervous system

Pain is still there but the patient doesn’t feel it

Once these drugs are metabolized, the pain returns

Question 4

How do non-opioids affect pain

Answer 4

Decrease or eliminate pain by inhibiting cyclooxygenase (COX)

Question 5

What does COX-1 inhibitors do

Answer 5

⬇️ prostaglandin that protects the stomach
⬇️ platelet aggregation
⬇️ renal function

Risk for ulcer, GI bleed and renal problems

protection from clotting that may cause MI or Stroke

Question 6

What happens when COX-2 inhibitors are given

Answer 6

⬆️ Vasoconstriction 
Decrease inflammation
Reduce pain
Reduce fever 
Protect from colorectal cancer development

NO risk for ulcer or GI bleed
CAN cause MI or stroke and renal damage bc of vasoconstriction

Question 7

Combo COX drugs

Answer 7

NSAIDS

• ibuprofen
• naproxen sodium
• aspirin

Question 8

COX-1 drug

Answer 8

Indomethacin

Question 9

Acetaminophen

Answer 9

Non-Opioid

Only reduce pain and fever

Can be used safely in patients who are at high risk bleeding, ulcers and renal damage

Highly liver toxic— toxic hepatitis

4000 mg/ day limit

• antidote= acetycysteine

Question 10

Methynaltrexone

Answer 10

Opioid Antagonist - block opioid receptors ONLY in the gastrointestinal track

Decreases opioid-induced constipation associated with anesthesia

• prevent post op ileus

Question 11

Naloxone (Narcan)

Answer 11

Strong opioid antagonist- blocks reception of opioid agonist like morphine

Is given IM, subq, IV or nasal spray

Works quickly to reverse it he sedation and respiratory depression seen with opioid overdose

Question 12

Medications used for headaches

Answer 12

Ergot derivatives ( erogotamine)

Triptans (sumatriptan)

• very effective with essentially no side effects
• when triptans are not completely effective, erogotamine may be added to decrease headache

Question 13

Sumatriptans

Answer 13

• treat migraine headaches by increasing the reception of serotonin
• cause constriction of intracranial blood vessels to eliminate pain, nausea, photophobia and phonophobia (sound) caused by dilated vessels I. The head putting pressure on surrounding tissue

Question 14

Teaching for combo cox

Answer 14

Take recommended dose
Monitor for bleeding 
Take w/ food
Don’t combine cox1 with combo 
Drink water (kidney function) 
Add on GI drug to protect stomach (PPI, H2RA)

Question 15

Side effects of narcotics

Answer 15

• don’t drive

⬇️ awareness
⬇️ RR, respiratory depression
Severe constipation
Over sedation

Question 16

ASA ( aspirin)

Answer 16

• salicylism = toxic = tinnitus
• risk for bleed
• enteric coated works in the intestine to avoid messing up stomach

Question 17

Cross sensitivity

Answer 17

Hypersensitivity = allergic

ASA ibuprofen

Allergic to one, don’t give to their bc they probably allergic to it o

Question 18

Cox-2 drug

Answer 18

Celebrex