Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Analgesics and Antiinflammatory #3 > Flashcards

Analgesics and Antiinflammatory #3 Flashcards

1
Q

What are three nursing interventions for narcotics?

A
  • Must have witness and Co-sign discarded or wasted medication
  • Ensure records and drug count matches
  • Double lock all narcotics and keys must be accounted for
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nursing interventions for narcotics are regulated by Federal, State, and Agency policies… These include:

A
  • Board of Nursing/ Nurse Practice Act
  • Board of Pharmacy
  • Ohio Revised Code
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F Pain is an unpleasant sensory and emotional experience.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F Pain requires good assessment and knowledge of pain to treat/ control adequately

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can prevent health care professionals from treating pain adequately? (4)

A
  • inadequate knowledge
  • poor assessment skills
  • concern about regulation of controlled substances
  • fear of patient addiction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why would a patient be reluctant to report pain/ take pain medications? (5)

A
  • culture
  • gender differences
  • inadequate description or reporting of pain
  • fear loss of control
  • side effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are problems related to the health care system that denies patients from receiving pain control? (3)

A
  • cost
  • access
  • “not being listened to”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are 3 main physiological stressors of unrelieved pain?

A
  • increased respiration rate
  • increased HR
  • increased BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 stress responses of unrelieved pain?

A
  • fluid retention
  • glucose intolerance
  • impaired immune response- pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can result from stress responses due to unrelieved pain?

A
  • constipation
  • weakness
  • confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is addiction?

A

psychological and physical dependence on a substance beyond normal voluntary control (usually after prolonged use of a substance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is dependence?

A

reliance of a substance, that is not present, will cause impairment of psychological or physical function (need regular use to prevent withdrawal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is tolerance?

A

requiring increased dose to maintain same effect (frequently occurs in with chronic pain, such as cancer pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Different types of pain include:

A
  • acute (pain occurs suddenly and responds to treatment)
  • chronic (pain persists for more that 6 months- difficult to treat or control)
  • somatic (pain of skeletal muscle, ligaments and joints)
  • visceral (pain from smooth muscle and organs)
  • vascular (pain from vascular or perivascular tissues—> contribute to headaches/ migraines)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Damaged cells release which chemical mediators?

A
  • prostaglandins (causes increased vasodilation, capillary permeability, pain, and fever)
  • bradykinins (causes increase capillary permeability)
  • serotonin (helps block the perception of pain in the brain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F Nociceptors are in all types of tissue

A

True (from the powerpoint, but what about the brain?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Non-opioid (OTC) medications include:

A
  • Acetaminophen (prototype) (which IS Tylenol)

- NSAIDs- example is Ibuprophen (prototype)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Opioids (narcotics, controlled substances) include:

A

-Morphine (prototype)- examples are methadone and oxycodone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are adjuvants/ what do they do?

A
  • used in addition to pain meds

- may control some types of pain, depending on the source (such as inflammation or neuropathic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some examples of adjuvants? (3)

A
  • corticosteroids
  • anitconvulsants
  • tri-cyclic antidepressants (TCA’s)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F Nonsteroidal Antiinflammatory Drugs (NSAIDs) are addictive and more potent that opiates.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

NSAIDs are used for what type of pain?

A

mild to moderate pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the effects of NSAIDs?

A
  • analgesic
  • antipyretic
  • antiiflammatory (except acetaminophen which have a minimal effect)
  • some have antiplatelet action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which NSAID has an very minimal antiiflammatory effect?

A

Acetaminophen (which IS Tylenol) :)

25
Q

NSAIDs relieve pain by effects on chemical medicators by:

A

inhibiting cycloxygenase which results in decreased prostaglandin synthesis

26
Q

Two types of cycloxygenase include:

A

COX-1- protects stomach and regulates platelets
COX-2- triggers pain and inflammation (COX 2 inhibitors can help control arthritis type pain, but can cause some cardiac problems)

27
Q

T/F ASA and many other NSAIDs inhibit both types of protaglandins.

A

True

28
Q

What do two types of prostaglandin do?

A
  • one causes increased vasodilation, capillary permeability, pain, and fever
  • another promotes the mucosal barrier (stomach lining) protecting the stomach from high acid food
29
Q

What are the different types of NSAIDs?

A
  • Salicylates- aspirin
  • COX-2 inhibitors- celecoxib (Celebrex) and rofecoxib (Vioxx)
  • Propionic acid group- ibuprofen (Motrin and Advil)
  • Others include naproxen (Aleve) and indomethacin (indocin)
30
Q

Side effects/ Adverse Reactions of NSAIDs include:

A
  • GI irritation, ulcers (due to inhibition of COX 1 and 2)
  • Inhibitor of platelet aggregation (increased bleeding tendencies, increase effect of anticoagulants, increase menstrual flow)
  • Hypersensitivities (vertigo and bronchospasm)
31
Q

T/F Aspirin can be given to children under the age of 12 for any fever?

A

False (if done, risk for Reye’s Syndrome)

32
Q

T/F Chronic use of NSAIDs can cause renal impairment (especially propionic group like Ibuprofen).

A

True

33
Q

T/F Acetaminophen is in 25% of all OTC meds sold (over 200 OTC preparations)

A

True

34
Q

T/F Acetaminophen has NO effect on gastric lining or platelets and has a fairly wide safety margin.

A

True

35
Q

What are the toxic effects of acetaminophen overdose and what increases that risk?

A
  • acute liver failure (hepatotoxicity)/hepatic necrosis

- When taken with Alcohol, the risk is increased

36
Q

How would you give to treat for an overdose of acetaminophen?

A

mucomist

37
Q

How can an overdose of acetaminophen occur?

A

-If you have more than 4 mg/day
or
-Long term use of more than 2 mg/day

38
Q

What are corticosteroids and what is important to note about them?

A
  • They suppress inflammation by inhibiting of the immune process–> depress lymphocyte activity
  • Must be tapered off (if used more than 1-2 weeks)
39
Q

What are some examples of corticosteroids?

A
  • prednisone
  • dexamethasone
  • solu-cortef
40
Q

What are side effects of corticosteroids?

A
  • glucose intolerance
  • weight gain
  • osteoporosis
  • skin changes
  • increased risk for infection/ poor healing
41
Q

What are some examples of DMARDs (Disease modifying antirheumatic drugs)?

A
  • Gold- used as antirheumatic (ex. gold salts- Ridaura, Solganal)
  • Immunosuppressive agents- inhibit inflammatory process
  • Immunomodulators
  • Antimalarials
42
Q

T/F Some antidepressants or anitconvulsants are used as adjunct drugs for pain (esp. neuropathic).

A

True

examples include: Gabapentin, Elavil, Pregabalin (Lyrica)

43
Q

What type of pain are narcotic analgesics used for?

A

moderate to severe pain

44
Q

What are some examples of narcotic analgesics?

A
  • morphine

- codeine

45
Q

What do narcotic analgesics do to the CNS?

A
  • suppress pain perception
  • suppress respiration
  • suppress cough (antitussive)
  • suppress GI motility= constipation
46
Q

What is important to know about morphine?

A
  • administered IM, IV, PO
  • very effective in acute, severe pain (offers euphoria)
  • relief of respiratory distress in terminal illness near death
  • effective in treating chronic pain if extended release forms
  • effective in acute heart failure (if pulmonary edema)-reduces preload, afterload, gives euphoira
47
Q

The synthetic narcotic, Meperidine (Demerol), has what characteristics?

A
  • no antitussive effect
  • very dangerous in renal insufficieny
  • can be neurotoxic (tremors and seizures)
  • does not diminish uterine contractions (may be given during labor for pain)
  • less constipation and urinary retention
  • Use with extreme selectivity
48
Q

T/F Tramadol (Ultram) binds to microreceptors, possibilly has no dependence, used for moderate to severe pain, and is contraindicated with alcohol and opioids.

A

True

49
Q

Narcotic Side effects/ Adverse reaction include:

A
  • respiratory depression (give narcan if resp. rate <10)
  • orthostatic hypotension
  • consitpation
  • N / V
  • Somnolence (drowsiness)
  • allergenic if rash/hives develop
  • tolerance and dependence
50
Q

What are some of the withdrawal symptoms?

A
  • agitation
  • tachycardia
  • HTN
  • GI symptoms
  • skin sensation of “crawling bugs”
51
Q

What should you monitor with a patient on a narcotic?

A

-respiratory rate (RR
any will need narcan
These occur if pt is opioid naive or drug has accumulated too much during renal or hepatic disease.

52
Q

When a patient is on narcotics, the nurse should pay special attention to:

A
  • Safety risk (BP changes, sedation)
  • Constipation
  • Caution if patient has liver or renal disease
  • Caution in elderly (lower dose)
  • Make accurate assessments
  • Listen to pt (what does/doesn’t work)
53
Q

Besides Naloxone (Narcan), what is another narcotic antagonist (anitdote)?

A

Naltrexone HCL (ReVia)

54
Q

What do narcotic antagonists do and how should they be given (not route)?

A
  • They compete for opiate receptors (“knock opiate off” to stop effect)
  • They must be given slowly and carefully
55
Q

What are some condraindications of Narcotic use?

A

-head injuries
-respiratory dysfunction (can be used to control cough)
-shock states (can decrease BP further)
-GI motility problems (can worse anticholinergic effects)….
can be used to control diarrhea in some patients

Make sure to evaluate risk vs. benefit

56
Q

T/F Combinations of narcotic agonists and antagonist result in less risk for tolerance to develop and can lower the narcotic dose needed.

A

True

57
Q

Examples of Combinations of narcotic agonists and antagonists include:

A
  • Pentazocine (Talwin)- most commonly used
  • Butorphanol tartrate (Stadol)
  • Buprenorphine (Buprenex)
58
Q

T/F Acetaminophen is Tylenol

A

True :)

Pharmacology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions