Analgesic Drug Information

Question 1

Codeine Sulfate

Answer 1

Used as a cough suppressant more often than for analgesic purposes

Question 2

Fentanyl (Duragesic, Oralet, Actiq)

Answer 2

Class: Opioid analgesic

Dosage: Start with lowest effective dose; IV/IM (50-100mcg); Duragesic (12.5-200mcg/hour every 72 hours); Oralet and Actiq (200mcg)

Indications: General anesthesia, sedation, moderate/severe pain relief, chronic pain relief

Route: IV, Transdermal, PO

Question 3

Hyrdomorphone (Dilaudid)

Answer 3

Class: Opioid analgesic

Dosage: IV/IM (0.25-1mg every 4-6 hours prn); Oral (2-4mg PO every 6 hours prn)

Indications: Seven times more potent than morphine

Route: IV

Question 4

Morphine Sulfate (MSIR, Roxanol)

Answer 4

Class: Opiate analgesic, opium alkaloid

Dosage: PO (10-30mg every 4 hours prn); IV/IM/Subcut (2.5-10mg every 2-6 hours prn)

Indications: Opioid analgesia

Route: IV

Question 5

Oxycodone

Answer 5

Class: Synthetic opioid

Dosage: PO (5-20mg every 4-6 hours prn)

Indications: Relief of moderate to severe pain

Route: PO

Question 6

Naloxone Hydrochloride (Narcan)

Answer 6

Class: Opioid antagonist

Dosage: IV (0.4-2mg)

Indications: Treatment of opioid overdose, post-operative anesthesia reversal

Route: IV

Question 7

Aceteminophen (Tylenol, others)

Answer 7

Class: Nonopioid analgesic, antipyretic

Dosage: PO/PR (325-650mg every 4-6 hours, do not exceed 3-4g/day)

Indications: Relief of mild to moderate pain

Route: PO

Question 8

Opioid-Induced Adverse Effects by Body System

Answer 8

CNS depression that leads to RESPIRATORY DEPRESSION
Nausea and vomiting
Urinary retention
Diaphoresis and flushing
Miosis
Constipation (long-term use)
Itching

Question 9

Opioid Adjuvant Drugs

Answer 9

NSAIDs (inflammation)
Antidepressants (chronic pain)
Anticonvulsants (neuropathic pain)
Corticosteroids (antiinflammatory)

Question 10

Opioid Indications

Answer 10

Moderate to severe pain
Cough center suppression
Treatment of diarrhea
Balanced anesthesia
Chest pain

Question 11

Opioid Contraindications

Answer 11

Known drug allergy
Severe asthma (lead to respiratory depression)
Respiratory insufficiency
Elevated intracranial pressure
Morbid obesity/sleep apnea
Paralytic ileus
Pregnancy

Question 12

Opioid Withdrawal Signs and Symptoms

Answer 12

Anxiety
Irritability
Chills and hot flashes
Joint pain
Lacrimation
Rhinorrhea
Diaphoresis
Nausea/vomiting
Abdominal cramps
Diarrhea
Confusion

Question 13

Negative Opioid Interactions

Answer 13

Alcohol
Antihistamines
Barbiturates
Benzodiazepines
Monoamine oxidase inhibitors

Question 14

Indications for Acetaminophen

Answer 14

Mild to moderate pain
Fever
Alternative for those who cannot take aspirin (children under 12)

Question 15

Acetaminophen Maximum Dosage

Answer 15

3000mg/day for healthy adults

2000mg/day for elderly or those with liver disease

Question 16

Acetaminophen Contraindications/Interactions

Answer 16

Drug allergy
Liver dysfunction
Possible liver failure
G6PD deficiency

Question 17

Acetaminophen Toxicity

Answer 17

Long-term use or overdose can lead to hepatotoxicity and nephropathy

Antidote is acetylcysteine regimen

Question 18

Nursing Implications

Answer 18

Perform a thorough history regarding allergies and other medications
Obtain baseline vital signs
Perform a pain assessment
Medicate BEFORE THE PAIN BECOMES SEVERE
Use other interventions
Oral forms should be taken with food
Respiratory rate should be more than 10-12 breaths/min