Analgesics (45) Flashcards
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)
2
Q
OXYCODONE: Side Effects
A
- Drowsiness, sedation
- Nausea, vomiting, anorexia
- Respiratory depression
- Constipation
- Confusion, headache
- Rash
- Euphoria
- Urinary retention
- Orthostatic hypotension
- Palpitations
3
Q
OXYCODONE: Purpose
A
Treatment of moderate to severe pain
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
5
Q
MORPHINE: Side Effects
A
- Respiratory depression
- Sedation
- Euphoria
- Orthostatic hypotension
- Bradycardia
- Diaphoresis
- Urticaria
6
Q
MORPHINE: Purpose
A
Treatment of severe pain
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
8
Q
METHADONE: Side Effects
A
- Drowsiness, sedation
- Nausea, vomiting, anorexia
- Respiratory depression
- Constipation, cramps
- Orthostatic hypotension
- Confusion, headache
- Rash
- Arrhythmias
- Agitation
9
Q
METHADONE: Purpose
A
Treatment of severe pain, detoxification/management of narcotic addiction
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
11
Q
MEPERIDINE: Side Effects
A
- Drowsiness, sedation
- Respiratory depression
- Orthostatic hypotension
- Confusion, headache
- Euphoria
- Bradycardia
- Diaphoresis
- Urticaria
12
Q
MEPERIDINE: Purpose
A
Treatment of moderate to severe pain
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
14
Q
HYDROMORPHONE: Side Effects
A
- Drowsiness, sedation
- Nausea, vomiting, anorexia
- Respiratory depression
- Constipation, cramps
- Orthostatic hypotension
- Confusion, headache
- Rash
15
Q
HYDROMORPHONE: Purpose
A
Treatment of moderate to severe pain and of nonproductive cough
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
17
Q
HYDROCODONE/ACETAMINOPHEN: Side Effects
A
- Dizziness
- Drowsiness
- Constipation
- Nausea
- Vomiting
- Respiratory depression
- Sedation
- Impairment of mental and physical performance
- Rash
- Pruritus
- Palpitations
18
Q
HYDROCODONE/ACETAMINOPHEN: Purpose
A
Treatment of moderate to severe pain
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
**TRAMADOL:** Nursing Considerations
* 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
**TRAMADOL:** Side Effects
* Dizziness, confusion
* Headache
* Orthostatic hypotension
* Abnormal ECG
* Visual disturbances
* Nausea, vomiting
* GI bleeding
* Urinary retention/frequency
* Rash
* Respiratory depression
27
**TRAMADOL:** Purpose
Management of moderate to severe pain and chronic pain
28
**NAPROXEN:** Nursing Considerations
* 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
**NAPROXEN:** Side Effects
* GI bleeding
* Blood dyscrasias
* Tinnitus
* Insomnia
* Vision changes
* Rash
* Angioedema
* Jaundice
* Tachycardia
* Nausea, vomiting, diarrhea
30
**NAPROXEN:** Purpose
Treatment of mild to moderate pain, reduction of inflammation
31
**IBUPROFEN:** Nursing Considerations
* 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
**IBUPROFEN:** Side Effects
* Headache
* Tinnitus
* Nausea, anorexia
* Dizziness
* Blood dyscrasias
* Constipation
* GI bleeding
33
**IBUPROFEN:** Purpose
Treatment of mild to moderate pain, reduction of inflammation
34
**CELECOXIB:** Nursing Considerations
* 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
**CELECOXIB:** Side Effects
* Fatigue
* Anxiety, depression, nervousness
* Nausea, vomiting, anorexia, dry mouth, constipation
* Dyspnea
* Back pain
* Tachycardia
* Dysuria
* Palpitations
36
**CELECOXIB:** Purpose
Management of acute chronic arthritis pain, relief of primary dysmenorrheal pain within 60 minutes
37
**ASPIRIN:** Nursing Considerations
* 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
**ASPIRIN:** Side Effects
* Nausea, vomiting
* Rash
* Dyspnea
* Tinnitus
* GI bleeding
39
**ASPIRIN:** Purpose
Management of mild to moderate pain or fever and TIA; prophylaxis of MI, ischemic stroke, and angina
40
**ACETAMINOPHEN/ASPIRIN/CAFFEINE:** Nursing Considerations
* 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
**ACETAMINOPHEN/ASPIRIN/CAFFEINE:** Side Effects
* Upset stomach, heartburn
* Depressed mood, anxious or restless feelings
* Insomnia
42
**Acetaminophen/Aspirin/Caffeine:** Purpose
Treatment of mild to moderate pain or fever
43
**ACETAMINOPHEN:** Nursing Considerations
* 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
**ACETAMINOPHEN:** Side Effects
* Anemia (long-term use)
* Liver and kidney failure
* Dyspnea (prolonged high doses)
* Angioedema
* Hives, itching
45
**ACETAMINOPHEN:** Purpose
treatment of mild pain or fever
