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Pharmacology Nursing > Analgesics & Musculoskeletal > Flashcards

Analgesics & Musculoskeletal Flashcards

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1
Q

OLDCARTS

A

Onset
Location
Duration
Character
Alleviating & Aggravating factors
Radiation
Treatments
Severity

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2
Q

PQRST

A

Provoking
Quality
Region & Radiation
Severity
Time

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3
Q

Nursing Implementation considerations for administering analgesics

A

Vital Signs
Pain Scale
Anticipate side effects
Regulations (controlled substances)

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4
Q

What and when should nursing evaluation occur after administering an analgesic?

A

30 to 60 minutes post administration
Rate pain
Evaluate side effects

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5
Q

The COX inhibitor (1 or 2) that decreases the production of gastric mucus.

A

COX 1

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6
Q

What are lifespan considerations for acetaminophen?

A

24 hour limits for geriatrics, alcoholics, and adults

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7
Q

To which organ is acetaminophen most toxic?

A

Liver

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8
Q

Why should you advise limiting consumption of acetaminophen to 3 days?

A

Hepatotoxicity

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9
Q

What routes can acetaminophen be administered?

A

PO
PR
IV

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10
Q

Why is it important to know all medications a patient is taking when considering the 24 hour limit for acetaminophen?

A

Many other medications contain acetaminophen

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11
Q

What physiologic effect do NSAIDs posses that acetaminophen does not?

A

Anti-inflammatory

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12
Q

What is the most common side effect of NSAIDs?

A

GI upset/irritation/bleeding

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13
Q

Can you administer an NSAID for a fever?

A

Yes
Antipyretic

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14
Q

What sensory side effect of aspirin would indicate an overdose or potential bleeding?

A

Tinnitus

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15
Q

What additional property does aspirin have that when given in low doses will have a beneficial cardiovascular effect?

A

Inhibits platelet aggregation

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16
Q

When giving aspirin to a person who consumes alcohol, what is the contraindication?

A

They both cause gastric irritation and can cause GI bleeding

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17
Q

What is the youngest age ibuprofen can be administered?

A

> 6 months of age

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18
Q

In what part of pregnancy is ibuprofen contraindicated?

A

3rd trimester

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19
Q

Why should the pt sit upright for 30 minutes after taking an NSAID?

A

To decrease GI irritation

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20
Q

What organ function is most likely to be adversely affected by NSAIDs?

A

Renal
monitor GFR and BUN and creatinine

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21
Q

Do NSAIDs (excluding aspirin) affect platelet aggregation?

A

Yes but not as strongly as aspirin

22
Q

What ages should you question ketolorac dosing?

A

No administration for less than 18 years of age
Reduced dosing after age of 65

23
Q

What NSAID can be used for breakthrough pain?

A

ketolorac

24
Q

What is the Black Box Warning for celecoxib?

A

Celecoxib
Increases risk for CV events, GI bleeding and GI perforation

25
Q

What conditions contraindicate administering celecoxib?

A

Hemorrhagic CVA
Recent CABG
Pre operative

26
Q

What do the Mu receptors affect?

A

Pain (analgesia)
Respiratory Depression
Euphoria
Depression
Sedation

27
Q

What receptors are affected by opioid analgesics

A

Mu
Kappa (mild activation)

28
Q

What type of pain is morphine given for?

A

Moderate to severe

29
Q

How does morphine (opioid analgesic) affect pain?

A

Works at CNS level
Alters perception and response to pain
Primarily affects Mu receptors

30
Q

What affect do opioids have on the GI system?

A

Slows movement
Constipation
Delays gastric emptying
Causes ileus/obstruction

31
Q

What should you assess before administering an opioid analgesic?

A

VS
Pain Level
Site of pain

32
Q

Differentiate between acute and chronic pain

A

Acute comes on suddenly and is usually caused by something specific; lasts less than 6 months
Chronic is ongoing and lasts more than 6 months

33
Q

What are the considerations that increase bleeding when administering NSAIDs?

A

10.6
> 60 years old
previous stomach ulcers or bleeding
anticoagulant use
steroid use
taking other NSAIDs
3 or more alcoholic drinks per day
takes medication longer than directed

34
Q

What is the Black Box Warning for ibuprofen?

A

Contraindicated for perioperative pain after CABGG

35
Q

What is the antidote for opioids?

A

naloxone

36
Q

What is the risk when giving opioids?
HINT- long-term

A

Misuse and abuse

37
Q

Why are opioids contraindicated in patients with a head injury?

A

Can elevate intracranial pressure
Can mask neuro findings of ICP

38
Q

What is the biggest concern when administering naloxone?

A

Immediate opioid withdraw

39
Q

What is the half life of naloxone?

A

About 60 minutes

40
Q

What is the classification of baclofen?

A

Muscle relaxant & antispasmotic

41
Q

What can happen if you abruptly stop administration of baclofen?

A

Hallucinations
Seizures

42
Q

List signs of baclofen overdose.

A

vomiting
muscle weakness
drowsiness
eye accommodation disorders
coma
respiratory depression
seizures

43
Q

What are the indications for giving cyclobenzaprine?

A

Acute muscle spasms

44
Q

What other medications (a patient is taking) would cause you to question giving cyclobenzaprine?

A

CNS depressants
Glaucoma medications
Medications that cause constipation
Antihypertensive (can cause orthostatic hypotension)
Antidepressants (Serotonin Syndrome)

45
Q

Are there any lifespan considerations when administering cyclobenzaprine? If so, what are they?

A

> 15 years of age
Geriatric reduced dosing
Renal impairment reduced dosing

46
Q

What side effects of cyclobenzaprine should you provide in your patient education?

A

Sedation
Orthostatic hypotension
Dizziness
Dry mouth
Urinary retention
Serotonin Syndrome

47
Q

What is the MOA for allopurinol?

A

Inhibit uric acid production and inhibition of xanthine oxidase (an enzyme that converts hypoxanthine to xanthine to uric acid)

48
Q

What lab value should you know before administering allopurinol?

A

Uric Acid level

49
Q

What assessment findings would indicate the effectiveness of allopurinol?

A

Decreased gout symptoms ( pain, warmth, redness and edema at affected joint)

50
Q

What is the indication for giving tizanidine?

A

Muscle spasms

Pharmacology Nursing (1 decks)

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