Analgesic Drugs (2) Flashcards
_______: pain that returns prior to next scheduled opioid treatment
breakthrough pain
what should you do if the normal opioid is not working and the patient is experiencing breakthrough pain
give another IV dose to lower the pain until the next normal dose
______ are the most common med type for neuropathic pain/issues
anticonvulsants
name medication types that have synergistic and adjuvant effects with analgesics (4)
- NSAIDs
- antidepressants (amitriptyline)
- anticonvulsants (gabapentin/ pregabalin)
- corticosteroids
recommended dose of acetaminophen for a healthy adult
3000 mg/day
recommended dose of acetaminophen for older patients or patients with liver failure
2000 mg/day
contraindications for acetaminophen
- liver dysfunction/failure (watch for meds causing hepatotoxicity)
- G6PD deficiency
what does an overdose of acetaminophen cause
hepatic necrosis and hepatotoxicity (liver failure/death)
what is the antidote for an overdose of acetaminophen
acetylcysteine
(tastes/smells like rotten eggs; may mix with flavoring or soda to mask it)
_______:
- nonopioid analgesic
- weak bond to opioid receptors & blocks norepinephrine and serotonin reuptake
- adverse effects similar to opioids
- careful use in patients taking SSRIs, MAOIs, neuroleptics
tramadol
______:
- nonopioid analgesic
- numbs local site (<12 hrs)
- skin irritation may occur
lidocaine
what can herbal products like feverfew be used for
- migraine, menstrual cramps, inflammation, fever
(Side effects – NVD, altered taste, muscle stiffness)
(Contraindications: NSAIDs; aspirin, anticoagulants)
3 step analgesic latter
- identification/assessment, then pain treatment
-step 1: nonopioids
-step 2: opioids
-step 3: opioids for moderate/severe pain
what is a contraindication of opioids that MUST be assessed prior to administering
respiratory insufficiency (assess respiratory status)
name some side/*adverse effects of opioids
- N/V, sweating, itching, flushing
- urinary retention, constipation, pupil constriction
- *CNS depression
- *respiratory depression (most serious)
what type of drugs have interactions with opioids
any sedating drugs
(alcohol, antihistamines, barbiturates, benzodiazepines, MAOIs)
____ requires a higher dose for pain relief
tolerance
______: physiologic need of pain meds to live life
dependency
(both tolerance and dependency are expected with long-term opioid meds)
______: psychological need and use for euphoria (“getting a high”)
addiction
when respiratory rate is _____ give antidote for opioid overdose/toxicity
<12 ; naloxone (narcan) is the antidots
codeine sulfate (schedule II) is and agonist opioid commonly used for what
(weak)
cough (antitussive)
oxycodone, morphine, hydromorphone (schedule II) are agonist opioids - are they strong or weak
strong
fentanyl (schedule II) is an agonist opioid that is ______
very strong
name some adverse effects of methadone (schedule II agonist)
cardiac dysrhythmias and unintentional overdoses from long half-life
opioid agonists-antagonists have a _____ risk for abuse than agonists
lower
(not strong enough to manage long-term chronic pain (due to mixed action))
what is the most common form of agonists-antagonists
nalbuphine (schedule IV)
DO NOT give agonists-antagonists with _____
opioid agonists
name an example of an opioid antagonist (antidotes)
naloxone
what should a nurse complete prior to beginning analgesic therapy
age-appropriate full pain assessment
(onset, provocation/palliation, region/radiation, severity, time)
_____ is a common adverse effect of analgesics and can be prevented with adequate fluid/fiber intake)
constipation
what should you monitor for during analgesic therapy
adverse effects - stop dosing with changes in vitals/patient condition)
