Analgesics

Question 1

Tissue injury causes the release of the following:

Answer 1

Bradykinin

ii. Histamine
iii. Potassium
iv. Prostaglandins
v. Serotonin

Question 2

3 types of analgesics

Answer 2

i. Opioids
ii. Nonopioid
iii. Nonopioid miscellaneous drugs

Question 3

Medications that relieve pain without causing loss of consciousness

Answer 3

analgesics

Question 4

Mild agonists

Answer 4

HYDROCODONE, codeine

Question 5

Strong agonists

Answer 5

MORPHINE, FETANYL, oxycodone, hydromorphone, methadone

Question 6

not recommended for long-term use because of the accumulation of a neurotoxic metabolite

Answer 6

NORMEPERIDINE (can cause seizures)

Question 7

The drugs most likely to lead to addiction are in

Answer 7

schedule I

Question 8

Those with the least potential for addiction are in

Answer 8

schedule V

Question 9

Ability to provide equivalent pain relief by calculating dosages of different drugs or routes of administration that provide comparable analgesia

Answer 9

Equianalgesia

Question 10

Example of equianalgesia

Answer 10

hydromorphone (dilaudid)

Question 11

opioids are used for:

Answer 11

Cough center suppression
treatment of diarrhea
balanced anesthesia

Question 12

Synthetic opioid (Schedule II) used to treat moderate to severe pain

Answer 12

Fentanyl

Question 13

Regardless of withdrawal symptoms, when a patient experiences severe respiratory depression,

Answer 13

an opioid antagonist should be given

Question 14

Pure opioid antagonist, Drug of choice for the complete or partial reversal of opioid-induced respiratory depression

Answer 14

Naloxone Hydrochloride (Narcan)

Question 15

Withhold dose and contact physician if there is a

Answer 15

decline in the patient’s condition or if vital signs are abnormal, especially if respiratory rate is less than 10 to 12 breaths/min

Question 16

Contraindications for opioid analgesics

Answer 16

a. Known drug allergy

b. Severe asthma

Question 17

Use with extreme caution in patients with:

Answer 17

i. Respiratory insufficiency
ii. Elevated intracranial pressure
iii. Morbid obesity or sleep apnea
iv. Paralytic ileus
v. Pregnancy

Question 18

Opioid Analgesics: Adverse Effects

Answer 18

a. CNS depression
i. Leads to respiratory depression
ii. Most serious adverse effect
b. Nausea and vomiting
c. Urinary retention
d. Diaphoresis and flushing
e. Pupil constriction (miosis)
f. Constipation
g. Itching

Question 19

Opioid Analgesics: Interactions (do not want to combined)

Answer 19

a. Alcohol
b. Antihistamines
c. Barbiturates
d. Benzodiazepines
e. Monoamine oxidase inhibitors (antidepressants)
f. Others

Question 20

Patient teaching with opioids

Answer 20

Best p! relief when drugs are taken on regular schedule

Question 21

Nonopioid analgesics

Answer 21

Acetaminophen

Tramdol

Question 22

Blocks pain impulses peripherally by inhibiting prostaglandin synthesis

Answer 22

acetaminophen

Question 23

i. Weak bond to mu opioid receptors

ii. Inhibits the reuptake of norepinephrine and serotonin (decreases pain)

Answer 23

tramadol hydrochloride

Question 24

Acetominophen contradinications

Answer 24

i. Drug allergy
ii. Liver dysfunction
iii. Possible liver failure
iv. G6PD deficiency

Question 25

Recommended antidote for hepatotoxicity of acetaminophen

Answer 25

Acetylcysteine regimen

Question 26

Adjuvant drugs (helper drugs)

Answer 26

NSAIDs
Antidepressants
Anticonvulsants
Corticosteroids

Question 27

Adjuvant drug for neuropathic pain

Answer 27

Gabapentin (anticonvulsant)

Question 28

Muscle relaxant example

Answer 28

Cyclobenzaprine (flexeril)

Question 29

Adverse effects of muscle relaxants

Answer 29

i. Euphoria
ii. Lightheadedness
iii. Dizziness
iv. Drowsiness
v. Fatigue
vi. Muscle weakness

Question 30

Muscle relaxants can cause

Answer 30

marked sedation

Question 31

Nursing implications for analgesic drugs

Answer 31

history of allergies
vital sines & I&O
potential disorders