Analgesics

Question 1

ACETAMINOPHEN

Tylenol

Answer 1

Non-opioid
◾Treatment of mild pain or fever
◾PO: onset less than 1 hour, peak 30 minutes to 2 hours,
duration4–6 hours
◾Rectal: onset slow, peak 1–2 hours, duration 3–4 hours
◾ Take crushed or whole with full glass of water
◾ Can give with food or milk to decrease GI upset
◾ Signs of chronic poisoning: rapid, weak pulse; dyspnea; cold,
clammy extremities
◾ Signs of chronic overdose: bleeding, bruising, malaise, fever,
sorethroat, anorexia, jaundice
◾ OTC; Preg Cat B

Side Effects: 
Anemia (long-term use)
Liver and kidney failure
Dyspnea (prolonged high doses)
Angioedema
Hives, itching

Question 2

ASPIRIN

Answer 2

Non-opioid
◾ Management of mild to moderate pain or fever, transient
ischemic attacks, prophylaxis of MI, ischemic stroke, angina
◾ PO: onset 15–30 minutes, peak 1–2 hours, duration 4–6 hours
◾ Rectal: onset slow, 20%–60% absorbed if retained 2–4 hours
◾ With long-term use, check for liver damage: dark urine,
clay-colored stools, yellowing of skin and sclera, itching,
abdominal pain, fever, diarrhea
◾ For arthritis, give 30 minutes before exercise; may take 2 weeks
before full effect is felt
◾ Discard tablets if vinegar-like smell
◾ Do not give to children or teens with flulike symptoms or chickenpox; Reye syndrome may develop
◾ OTC; Preg Cat C

Side Effects:
Nausea, vomiting
Rash, Angioedema, Dyspnea, Melena, Tinnitus, GI bleeding

Question 3

CELECOXIB

Celebrex

Answer 3

Non-opioid
◾ Management of acute, chronic arthritis pain and primary
dysmenorrheal pain relief within 60 minutes
◾ Onset: 24–48 hours, duration 12–24 hours
◾ Can take without regard to meals
◾ Increasing doses do not appear to increase effectiveness
◾ Do not take if allergic to sulfonamides, aspirin, or NSAIDs
◾ Rx; Preg Cat C for first and second trimester; Preg Cat D for
thirdtrimester

Side Effects:
Fatigue
Anxiety, depression, 
nervousness
Nausea, vomiting, anorexia, 
drymouth, constipation
Angioedema, Hives,Dyspnea, Back pain, Tachycardia, Jaundice, Dysuria

Kaplan ( ). NCLEX-RN Drug Guide: 300 Medications You Need to Know for the Exam (Page 14). . Kindle Edition.

Question 4

IBUPROFEN

Advil, Motrin IB

Answer 4

Non-opioid
◾ Treatment of rheumatoid arthritis, osteoarthritis, primary
dysmenorrhea, gout, dental pain, musculoskeletal disorders, fever
◾ Onset: 30 minutes, peak 1–2 hours
◾ Contact clinician if ringing or roaring in ears, which may
indicatetoxicity
◾ Contact clinician if changes in urinary pattern, increased weight,
edema, increased pain in joints, fever, or blood in urine, which may
indicate kidney damage
◾ Use sunscreen to prevent photosensitivity
◾ Avoid use with ASA, NSAIDs, and alcohol, which may precipitate
GI bleeding
◾ Avoid use with anticoagulants
◾ May have an increased risk of MI or stroke
◾ OTC, Rx; Preg Cat B

Side Effects:
Headache, Tinnitus
Nausea, anorexia, Dizziness, Blood dyscrasias, Constipation, GI bleeding

Question 5

NAPROXEN
(Aleve [OTC], Anaprox, Anaprox DS,
Naprelan, EC-Naprosyn, Naprosyn)

Answer 5

Opioid
◾ Management of mild to moderate pain
◾ Treatment of rheumatoid, juvenile, and gouty arthritis; osteoarthritis;
primary dysmenorrhea
◾ Patients with asthma, ASA hypersensitivity, or nasal polyps have
increased risk of hypersensitivity
◾ Contact clinician if blurred vision or ringing or roaring in ears, which
may indicate toxicity
◾ Contact clinician if black stools, flulike symptoms
◾ Contact clinician if changes in urinary pattern, increased weight,
edema, increased pain in joints, fever, or blood in urine, which may
indicate kidney damage
◾ Avoid use with ASA, steroids, and alcohol
◾ May increase risk of MI or stroke
◾ OTC, Rx; Preg Cat B

Side Effects:
GI bleeding
Blood dyscrasias, Tinnitus, Headache, Insomnia, Vision changes, Rash, Angioedema, Jaundice, Tachycardia, Back pain, Nausea

Question 6

CODEINE

Answer 6

Opioid
◾ Treatment of moderate to severe pain, nonproductive cough
◾ PO: onset 30–45 minutes, peak 60–120 minutes, duration 4–6hours
◾ IM/subQ: onset 10–30 minutes, peak 30–60 minutes, duration
4–6hours
◾ Do not give if respirations are less than 12 per minute
◾ Avoid use with alcohol, CNS depressants
◾ Withdrawal symptoms may occur: nausea, vomiting, cramps,
fever,faintness, anorexia
◾ Physical dependency may result from long-term use
◾ Rx C-II, III, IV, V (depends on route); Preg Cat C

Side Effects:
Drowsiness, sedation
Nausea, vomiting, 
anorexia, Respiratory 
depression, Constipation, Orthostatic , hypotension, Dysuria, Hives, Dyspnea
Syncope, Angioedema

Question 7

HYDROCODONE BITARTRATE
& ACETAMINOPHEN
(Vicodin)

Answer 7

Opioid
◾ Used for relief of moderate to moderately severe pain
◾ Use with CNS depressants and/or alcohol may result in addictive
CNS depression
◾ May be habit-forming
◾ Avoid alcohol during treatment
◾ Use with caution in patients with pulmonary considerations
◾ Rx C-III; Preg Cat C

Side Effects:
Dizziness, Drowsiness
Constipation, Nausea, Vomiting
Respiratory depression
Sedation
Impairment of mental and 
physical performance
Rash, Pruritus

Question 8

HYDROMORPHONE

Dilaudid

Answer 8

Opioid
◾ Treatment of moderate to severe pain, nonproductive cough
◾ PO: onset 15–30 minutes, peak 30–60 minutes, duration 4–6 hours
◾ IM: onset 15 minutes, peak 30–60 minutes, duration 4–5 hours
◾ IV: onset 10–15 minutes, peak 15–30 minutes, duration 2–3 hours
◾ subQ: onset 15 minutes, peak 30–90 minutes, duration 4 hours
◾ Rectal: duration 6–8 hours
◾ Do not give if respirations are less than 12 per minute
◾ Avoid use with alcohol, CNS depressants
◾ Withdrawal symptoms may occur: nausea, vomiting, cramps, fever,
faintness, anorexia
◾ Physical dependency may result from long-term use
◾ Elderly patients may require lower doses
◾ Rx C-II; Preg Cat C

Side Effects:
Drowsiness, sedation
Nausea, vomiting, anorexia
Respiratory depression
Constipation, cramps
Orthostatic hypotension
Confusion, headache
Rash

Question 9

MEPERIDINE

Demerol

Answer 9

Opioid
◾ Management of moderate to severe pain, pre-op sedation, post-op, and
OBanalgesia
◾ PO: onset 10–15 minutes, peak 30–60 minutes, duration 2–4 hours (usually 3)
◾ IM: onset 10–15 minutes, peak 30–50 minutes, duration 2–4 hours (usually 3)
◾ IV: onset less than 5 minutes, peak 5-7 minutes, duration 2–4 hours (usually 3)
◾ subQ: onset 10–15 minutes, peak 30–50 minutes, duration 2–4 hours (usually 3)
◾ Do not give if respirations are less than 12 per minute
◾ Avoid use with alcohol, CNS depressants
◾ Withdrawal symptoms may occur: nausea, vomiting, cramps, fever, faintness,
anorexia
◾Physical dependency may result from long-term use
◾ Do not co-infuse with barbiturates, aminophylline, heparin, morphine,
methicillin, phenytoin, sodium bicarbonate, sulfadiazine, or sulfisoxazole
◾ Rx C-II; Preg Cat C

Side Effects:
Drowsiness, sedation, Respiratory 
depression, Euphoria, Orthostatic , hypotension
Confusion, headache
Bradycardia, Diaphoresis
Urticaria

Question 10

METHADONE

Dolophine, Methadose

Answer 10

Opioid
◾ Relief of pain, detoxification/maintenance of narcotic addiction
◾ PO: onset 30–60 minutes, peak 30–60 minutes, duration 4–6 hours
(withcontinuous dosing, duration of action may increase to 22 to 48 hours)
◾ IM: onset 10–20 minutes, peak 60–120 minutes, duration 4–5 hours
(withcontinuous dosing, duration of action may increase to 22 to 48 hours)
◾ IV: onset peak 15–30 minutes, duration 3–4 hours
◾ Do not give if respirations are less than 12 per minute
◾ Avoid use with alcohol, CNS depressants
◾ Withdrawal symptoms may occur: nausea, vomiting, cramps, fever,
faintness, anorexia
◾ Physical dependency may result from long-term use
◾ Rx C-II; Preg Cat C

Side Effects:
Drowsiness, sedation
Nausea, vomiting, anorexia
Respiratory
depression, Constipation, cramps, Orthostatic
hypotension, Confusion, headache, Rash, Arrhythmias, Syncope, Agitation, Diaphoresis, Hypokalemia
Pulmonary edema

Question 11

MORPHINE
(Astramorph PF, Avinza, Duramorph,
Infumorph, Kadian, MS Contin)

Answer 11

Opioid
◾ Management of severe pain
◾ Continuous dosing is more effective than prn; may be given by patientcontrolled analgesia (PCA)
◾ PO: onset 15–60 minutes, peak 30–60 minutes, duration 3–6 hours
◾ IM: onset 10–15 minutes, peak 30–50 minutes, duration 2–4 hours
(usually 3)
◾ IV: onset less than 5 minutes, peak 18 minutes, duration 3–6 hours
◾subQ: onset 10–15 minutes, peak 30–50 minutes, duration 2–4 hours
(usually 3)
◾ Withdrawal symptoms may occur: nausea, vomiting, cramps, fever,
faintness, anorexia
◾ Physical dependency may result from long-term use
◾ Monitor for increased respiratory and CNS depression when given
with cimetidine, clomipramine, nortriptyline, or amitriptyline
◾ Rx C-II; Preg Cat C

Side Effects:
Respiratory depression, Sedation, Euphoria
Orthostatic hypotension, Bradycardia, Diaphoresis
Urticaria

Question 12

OXYCODONE
(OxyContin; with aspirin Percodan,
with acetaminophen Percocet)

Kaplan ( ). NCLEX-RN Drug Guide: 300 Medications You Need to Know for the Exam (Page 21). . Kindle Edition.

Answer 12

Opioid
◾ Management of moderate to severe pain
◾ PO: peak 30–60 minutes, duration 4–6 hours
◾ Controlled-release: peak 3–4 minutes, duration 12 hours
◾ Do not give if respirations are less than 12 per minute
◾ Avoid use with alcohol, CNS depressants
◾ Withdrawal symptoms may occur: nausea, vomiting, cramps, fever,
faintness, anorexia
◾ Physical dependency may result from long-term use
◾ Rx C-II; Preg Cat B (controlled-release); Preg Cat C (Percocet)

Side Effects:
Drowsiness, sedation
Nausea, vomiting, anorexia
Respiratory depression
Constipation, cramps
Confusion, headache
Rash, Euphoria
Urinary retention
Orthostatic hypotension
Edition.