Analgesics (45) Flashcards

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1
Q

OXYCODONE: Nursing Considerations

A
  • 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)
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2
Q

OXYCODONE: Side Effects

A
  • Drowsiness, sedation
  • Nausea, vomiting, anorexia
  • Respiratory depression
  • Constipation
  • Confusion, headache
  • Rash
  • Euphoria
  • Urinary retention
  • Orthostatic hypotension
  • Palpitations
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3
Q

OXYCODONE: Purpose

A

Treatment of moderate to severe pain

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4
Q

MORPHINE: Nursing Considerations

A
  • Continuous dosing is more effective than prn; may be given by patient-controlled 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
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5
Q

MORPHINE: Side Effects

A
  • Respiratory depression
  • Sedation
  • Euphoria
  • Orthostatic hypotension
  • Bradycardia
  • Diaphoresis
  • Urticaria
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6
Q

MORPHINE: Purpose

A

Treatment of severe pain

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7
Q

METHADONE: Nursing Considerations

A
  • PO: onset 30–60 minutes, peak 30–60 minutes, duration 4–6 hours (with continuous dosing, duration of action may increase to 22–48 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
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8
Q

METHADONE: Side Effects

A
  • Drowsiness, sedation
  • Nausea, vomiting, anorexia
  • Respiratory depression
  • Constipation, cramps
  • Orthostatic hypotension
  • Confusion, headache
  • Rash
  • Arrhythmias
  • Agitation
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9
Q

METHADONE: Purpose

A

Treatment of severe pain, detoxification/management of narcotic addiction

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10
Q

MEPERIDINE: Nursing Considerations

A
  • 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
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11
Q

MEPERIDINE: Side Effects

A
  • Drowsiness, sedation
  • Respiratory depression
  • Orthostatic hypotension
  • Confusion, headache
  • Euphoria
  • Bradycardia
  • Diaphoresis
  • Urticaria
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12
Q

MEPERIDINE: Purpose

A

Treatment of moderate to severe pain

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13
Q

HYDROMORPHONE: Nursing Considerations

A
  • 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
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14
Q

HYDROMORPHONE: Side Effects

A
  • Drowsiness, sedation
  • Nausea, vomiting, anorexia
  • Respiratory depression
  • Constipation, cramps
  • Orthostatic hypotension
  • Confusion, headache
  • Rash
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15
Q

HYDROMORPHONE: Purpose

A

Treatment of moderate to severe pain and of nonproductive cough

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16
Q

HYDROCODONE/ACETAMINOPHEN: Nursing Considerations

A
  • 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
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17
Q

HYDROCODONE/ACETAMINOPHEN: Side Effects

A
  • Dizziness
  • Drowsiness
  • Constipation
  • Nausea
  • Vomiting
  • Respiratory depression
  • Sedation
  • Impairment of mental and physical performance
  • Rash
  • Pruritus
  • Palpitations
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18
Q

HYDROCODONE/ACETAMINOPHEN: Purpose

A

Treatment of moderate to severe pain

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19
Q

CODEINE: Nursing Considerations

A
  • PO: onset 30–45 minutes, peak 60–120 minutes, duration 4–6 hours
  • IM/subQ: onset 10–30 minutes, peak 30–60 minutes, duration 4–6 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, III, IV, V (depends on route); Preg Cat C
20
Q

CODEINE: Side Effects

A
  • Drowsiness, sedation
  • Nausea, vomiting, anorexia
  • Respiratory depression
  • Constipation
  • Orthostatic hypotension
  • Dysuria
  • Dyspnea
  • Seizures
  • Bradycardia
21
Q

CODEINE: Purpose

A

Treatment of moderate to severe pain and of nonproductive cough

22
Q

BUPRENORPHINE/NALOXONE: Nursing Considerations

A
  • Avoid hazardous activities until reaction known
  • Avoid alcohol and CNS depressants
  • IM: onset 15 minutes, peak 1 hour
  • IV: onset 1 minute, peak 5 minutes
  • SL: onset and peak unknown
  • Rx C-V (parenteral), C-III (tablet)
23
Q

BUPRENORPHINE/NALOXONE: Side Effects

A
  • Drowsiness
  • Sleepiness
  • Itching, rash
  • Blurred vision
  • Palpitations, tachycardia
  • Headache
  • Mental changes
  • Hepatotoxicity
  • Respiratory depression
24
Q

BUPRENORPHINE/NALOXONE: Purpose

A

Management of severe pain, treatment of opioid dependence

25
Q

TRAMADOL: Nursing Considerations

A
  • Give with antiemetic for nausea, vomiting
  • Take with or without food
  • May cause serotonin or neuroleptic malignant syndrome–like reactions
  • Avoid OTC medications unless approved by provider
  • Rx
26
Q

TRAMADOL: Side Effects

A
  • Dizziness, confusion
  • Headache
  • Orthostatic hypotension
  • Abnormal ECG
  • Visual disturbances
  • Nausea, vomiting
  • GI bleeding
  • Urinary retention/frequency
  • Rash
  • Respiratory depression
27
Q

TRAMADOL: Purpose

A

Management of moderate to severe pain and chronic pain

28
Q

NAPROXEN: Nursing Considerations

A
  • Treatment of rheumatoid, juvenile, and gouty arthritis; osteoarthritis; primary dysmenorrhea
  • Patients with asthma, ASA hypersensitivity, or nasal polyps have increased risk of hypersensitivity
  • Contact provider if blurred vision or ringing or roaring in ears, which may indicate toxicity
  • Contact provider if black stools, flulike symptoms
  • Contact provider 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
29
Q

NAPROXEN: Side Effects

A
  • GI bleeding
  • Blood dyscrasias
  • Tinnitus
  • Insomnia
  • Vision changes
  • Rash
  • Angioedema
  • Jaundice
  • Tachycardia
  • Nausea, vomiting, diarrhea
30
Q

NAPROXEN: Purpose

A

Treatment of mild to moderate pain, reduction of inflammation

31
Q

IBUPROFEN: Nursing Considerations

A
  • Treatment of rheumatoid arthritis, osteoarthritis, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, fever
  • Onset: 30 minutes, peak 1–2 hours
  • Take with food or milk to decrease GI symptoms
  • Contact provider if ringing or roaring in ears, which may indicate toxicity
  • Contact provider 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
  • OTC, Rx; Preg Cat B
32
Q

IBUPROFEN: Side Effects

A
  • Headache
  • Tinnitus
  • Nausea, anorexia
  • Dizziness
  • Blood dyscrasias
  • Constipation
  • GI bleeding
33
Q

IBUPROFEN: Purpose

A

Treatment of mild to moderate pain, reduction of inflammation

34
Q

CELECOXIB: Nursing Considerations

A
  • Onset: 24–48 hours, duration 12–24 hours
  • Can take without regard to meals
  • Do not take if allergic to sulfonamides, aspirin, or NSAIDs
  • Rx
35
Q

CELECOXIB: Side Effects

A
  • Fatigue
  • Anxiety, depression, nervousness
  • Nausea, vomiting, anorexia, dry mouth, constipation
  • Dyspnea
  • Back pain
  • Tachycardia
  • Dysuria
  • Palpitations
36
Q

CELECOXIB: Purpose

A

Management of acute chronic arthritis pain, relief of primary dysmenorrheal pain within 60 minutes

37
Q

ASPIRIN: Nursing Considerations

A
  • 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
38
Q

ASPIRIN: Side Effects

A
  • Nausea, vomiting
  • Rash
  • Dyspnea
  • Tinnitus
  • GI bleeding
39
Q

ASPIRIN: Purpose

A

Management of mild to moderate pain or fever and TIA; prophylaxis of MI, ischemic stroke, and angina

40
Q

ACETAMINOPHEN/ASPIRIN/CAFFEINE: Nursing Considerations

A
  • Do not give to children or teenagers with fever, flu symptoms, or chickenpox; Reye syndrome may develop
  • Watch out for symptoms of stomach bleeding or liver problems
41
Q

ACETAMINOPHEN/ASPIRIN/CAFFEINE: Side Effects

A
  • Upset stomach, heartburn
  • Depressed mood, anxious or restless feelings
  • Insomnia
42
Q

Acetaminophen/Aspirin/Caffeine: Purpose

A

Treatment of mild to moderate pain or fever

43
Q

ACETAMINOPHEN: Nursing Considerations

A
  • PO: onset less than 1 hour, peak 30 minutes to 2 hours, duration 4–6 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, sore throat, anorexia, jaundice
  • OTC; Preg Cat B
44
Q

ACETAMINOPHEN: Side Effects

A
  • Anemia (long-term use)
  • Liver and kidney failure
  • Dyspnea (prolonged high doses)
  • Angioedema
  • Hives, itching
45
Q

ACETAMINOPHEN: Purpose

A

treatment of mild pain or fever