Analgesics

Question 1

CLASS:

Analgesics/Non-opioid; Antipyretic

Answer 1

acetaminophen (Tylenol)

USE: pain, fever
CONTRAINDICATIONS: liver disease, alcohol consumption, warfarin (coumadin)

SE: drowsiness or stimulation, rash, urticaria

ADV SE: hepatotoxicity, GI bleeding, leukopenia, neutropenia, thrombocytopenia

TEACHING: no >4 g, no alcohol

ANTIDOTE: acetylcysteine

Question 2

CLASS: NSAID

Answer 2

ketorolac (Toradol), ibuprofen (Advil, Motrin), naproxen sodium (Anaprox, Aleve), meloxicam (Mobic)

USE: mild to moderate pain

CONTRAINDICATIONS: pregnancy, hypersensitivity, asthma, hepatic disease, peptic ulcer disease

SE: dizziness, tremors, tinnitus, n/v/d, flatulence, dry mouth, drowsiness, headache, blurred vision, anorexia, constipation, cramps

ADV SE: seizures, MI, stroke, GI bleeding, hepatic failure, nephrotoxicity, hematuria, angioedema

TEACHING: report blurred vision and tinnitus (= toxicity), avoid driving, alcohol, salicylates, other NSAIDS

Question 3

CLASS: Opioids

Answer 3

hydromorphone (Dilaudid), morphine sulfate, oxycodone, hydrocodone, fentanyl (Duragesic), tramadol (Ultram)

USE: moderate to severe pain, cancer pain, Morphine for MI

CONTRAINDICATIONS: GI obstruction, may mask gallbladder pain

SE: constipation, sleepiness, n/v, itching, confusion, anorexia

ADV SE: Respiratory depression, ortho hypo, ↑ ICP

NRSG: Monitor for hypotension and RR depression

TEACHING: do not crush ext-rel tabs, drink 8-10 8oz fluids/day, eat high fiber/roughage

ANTIDOTE: naloxone (Narcan)

Question 4

CLASS:

Salicylate - Mild Analgesic

Answer 4

acetylsalicylic acid (Aspirin)

USE: MI, stroke, mild to moderate pain relief

CONTRAINDICATIONS: sensitivity, GI bleeding, Vitamin K deficiency, cerebral hemorrhage

SE: GI distress

ADV SE: GI bleeding, ulcer

NRSG: chewable tab 160-325 mg PO at onset of chest pain; observe signs of bleeding

TEACHING: take w/ food/milk/water, do not crush enteric-coated tabs, do not give to children w/ flu/virus, do not take with alcohol