Analgesic Drugs (2)

Question 1

_______: pain that returns prior to next scheduled opioid treatment

Answer 1

breakthrough pain

Question 2

what should you do if the normal opioid is not working and the patient is experiencing breakthrough pain

Answer 2

give another IV dose to lower the pain until the next normal dose

Question 3

______ are the most common med type for neuropathic pain/issues

Answer 3

anticonvulsants

Question 4

name medication types that have synergistic and adjuvant effects with analgesics (4)

Answer 4

• NSAIDs
• antidepressants (amitriptyline)
• anticonvulsants (gabapentin/ pregabalin)
• corticosteroids

Question 5

recommended dose of acetaminophen for a healthy adult

Answer 5

3000 mg/day

Question 6

recommended dose of acetaminophen for older patients or patients with liver failure

Answer 6

2000 mg/day

Question 7

contraindications for acetaminophen

Answer 7

• liver dysfunction/failure (watch for meds causing hepatotoxicity)
• G6PD deficiency

Question 8

what does an overdose of acetaminophen cause

Answer 8

hepatic necrosis and hepatotoxicity (liver failure/death)

Question 9

what is the antidote for an overdose of acetaminophen

Answer 9

acetylcysteine

(tastes/smells like rotten eggs; may mix with flavoring or soda to mask it)

Question 10

_______:
- 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

Answer 10

tramadol

Question 11

______:
- nonopioid analgesic
- numbs local site (<12 hrs)
- skin irritation may occur

Answer 11

lidocaine

Question 12

what can herbal products like feverfew be used for

Answer 12

• migraine, menstrual cramps, inflammation, fever

(Side effects – NVD, altered taste, muscle stiffness)
(Contraindications: NSAIDs; aspirin, anticoagulants)

Question 13

3 step analgesic latter

Answer 13

• identification/assessment, then pain treatment

-step 1: nonopioids
-step 2: opioids
-step 3: opioids for moderate/severe pain

Question 14

what is a contraindication of opioids that MUST be assessed prior to administering

Answer 14

respiratory insufficiency (assess respiratory status)

Question 15

name some side/*adverse effects of opioids

Answer 15

• N/V, sweating, itching, flushing
• urinary retention, constipation, pupil constriction
• *CNS depression
• *respiratory depression (most serious)

Question 16

what type of drugs have interactions with opioids

Answer 16

any sedating drugs

(alcohol, antihistamines, barbiturates, benzodiazepines, MAOIs)

Question 17

____ requires a higher dose for pain relief

Answer 17

tolerance

Question 18

______: physiologic need of pain meds to live life

Answer 18

dependency

(both tolerance and dependency are expected with long-term opioid meds)

Question 19

______: psychological need and use for euphoria (“getting a high”)

Answer 19

addiction

Question 20

when respiratory rate is _____ give antidote for opioid overdose/toxicity

Answer 20

<12 ; naloxone (narcan) is the antidots

Question 21

codeine sulfate (schedule II) is and agonist opioid commonly used for what

(weak)

Answer 21

cough (antitussive)

Question 22

oxycodone, morphine, hydromorphone (schedule II) are agonist opioids - are they strong or weak

Answer 22

strong

Question 23

fentanyl (schedule II) is an agonist opioid that is ______

Answer 23

very strong

Question 24

name some adverse effects of methadone (schedule II agonist)

Answer 24

cardiac dysrhythmias and unintentional overdoses from long half-life

Question 25

opioid agonists-antagonists have a _____ risk for abuse than agonists

Answer 25

lower

(not strong enough to manage long-term chronic pain (due to mixed action))

Question 26

what is the most common form of agonists-antagonists

Answer 26

nalbuphine (schedule IV)

Question 27

DO NOT give agonists-antagonists with _____

Answer 27

opioid agonists

Question 28

name an example of an opioid antagonist (antidotes)

Answer 28

naloxone

Question 29

what should a nurse complete prior to beginning analgesic therapy

Answer 29

age-appropriate full pain assessment

(onset, provocation/palliation, region/radiation, severity, time)

Question 30

_____ is a common adverse effect of analgesics and can be prevented with adequate fluid/fiber intake)

Answer 30

constipation

Question 31

what should you monitor for during analgesic therapy

Answer 31

adverse effects - stop dosing with changes in vitals/patient condition)