Analgesic Drugs

Question 1

What are analgesic drugs?

Answer 1

medications that relieve pain without causing a loss of consciousness

Question 2

Acute pain

Answer 2

-sudden onset
-subsides when treated

Question 3

Chronic pain

Answer 3

-persists/recurring, difficult to treat
-last 3-6 months

Question 4

Pain threshold

Answer 4

-the amount of stimulus needed to produce the perception of pain
-measure of the physiologic response of the nervous sytem

Question 5

Pain tolerance

Answer 5

amount of pain tolerated without interference of normal function

Question 6

What are adjuvant drugs?

Answer 6

assists primary drugs in relieving pain
-NSAIDS
-corticosteroids

For neuropathic pain
-antidepressants
-anticonvulsants

Question 7

What adjuvant drugs are given for neuropathic pain?

Answer 7

Gabapentin ot pregabalin (anticonvulsant)
-Amitriptyline (antidepressant)

Question 8

What are the opioid drugs?

Answer 8

Mild agonists
-codeine
-hydrocodone
Strong agonists
-morphine
-hydromorphone
-oxycodone
-mepertidine
-fentanyl
-methadone

Question 9

Contraindications to opioid analgesics

Answer 9

-respiratory insufficiency/asthma
-elevated intraocular pressure
-pregnancy
-morbid obesity/sleep apnea
-paralytic ileus

Question 10

Adverse effects of opioid analgesics

Answer 10

-respiratory depression (most severe)
-constipation (most common)
-dry mouth
-pupil constriction (miosis)
-sweating/flushing
-urinary retention
-itching

Question 11

Opioid patient teaching

Answer 11

-no driving
-rise slowly, to prevent orthostatic hypotension
-opioids decrease HR/BP, slows breathing down

Question 12

What receptors are involved in opioid function

Answer 12

Mu receptor, which is responsible for addiction
-opioids bind to Mu receptor

Question 13

What is the normal RR range

Answer 13

12-20 bpm

Question 14

Antidote for opioid overdose

Answer 14

Naloxone (narcan)
-can use as many times until the pt is awake
-use even if you suspect acute overdose

Question 15

What medication is given for opioid and alcohol addiction

Answer 15

Naltrexone (ReVia)

Question 16

Opioid withdrawal or abstinence symptoms

Answer 16

-anxiety
-irritability
-chills
-lacrimation, rhinorrhea, diaphoresis
-abdominal cramps
-dirrhea
-HR decreases, will feel cold

THINK WET S/S

Question 17

Interactions w/ opioids

Answer 17

-alcohol
-antihistamines (makes sleep, slow)
-barbiturates (sleepy, slow)
-benzodiazepines
-MAOIs

Question 18

Morphine Sulfate

Answer 18

-opioid, strong agonists
-severe pain high abuse potential
-prototype of all opioids

Question 19

Embeda

Answer 19

morphine and naltrexone, newest morphine product

Question 20

Fentanyl

Answer 20

for moderate to severe pain
-0.1 mg IV is equivalent to 10mg of Morphine IV

Question 21

Methadone (Dolophine)

Answer 21

opioid used for addiction

Question 22

Nalbuphine (Nubain)

Answer 22

an opioid agonists-antagonists w/ a mixed action
-lower risk of addiction
-not strong enough to manage long term pain
-do not give w/ full opioid agonists
-use w/ caution in respiratory insufficiency

Question 23

Maximum daily dose for acetaminophen

Answer 23

-3,000mg or 3g for health adults
-2,000mg for older adults/those w/ liver disease
-check for jaundice in pt taking this, can indicate liver damage

Question 24

Acetaminophen contraindications

Answer 24

-liver dysfunction
-possible liver failure
-nephrotoxic/nephropathy (kidney disease)

Question 25

Antidote for acetaminophen

Answer 25

acetylcysteine

Question 26

Lidocaine transdermal

Answer 26

-topical anesthetic
-left in place no longer then 12 hours, 12 hours on 12 off
-minimal AE, can cause skin irritation

Question 27

When do we give pain medicine?

Answer 27

before pain becomes severe , give ASAP, don’t wait for it to get worse

Question 28

Movantik and Relistor medications

Answer 28

indicated for opioid induced constipation