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NRSG 210 > Chapter 41 Non opioid analgesics > Flashcards

Chapter 41 Non opioid analgesics Flashcards

1
Q

what are the the seven main principles of pain management***

A

-Immediate goal is to reduce pain so that a person can perform ADLS
-patient should be considered expert in their own pain
-pain management is a patients right
-Non pharmacological interventions should be encouraged because of less adverse effects
-combo therapy is best (opioid non opioid) since it reduces adverse effects
-dosing should be individualized
-adverse effects should be anticipated and prevented

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2
Q

what is a useful way to create an objective rating for pain***

A

use a pain scale ie pain on a scale of 1-10

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3
Q

why is around the clock dosing important for pain management

A

because it is easier to maintain pain free level than eliminate escalating pain

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4
Q

what are the 5 common truths about pain***

A

-Patients who are in pain may not appear to be in pain
-Patients can sleep when their in pain
-Very few patients become addicted to their medication (0.01%)
-patients who are addicted to medication do not necessarily over report pain because they are drug seeking
-Vital signs are not a reliable indicator of pain

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5
Q

What is the definition of analgesia

A

absence of sensibility to pain

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6
Q

what is another indication of tricyclic antidepressants besides depression***

A

used for neuropathic pain

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7
Q

at what stage of the analgesic ladder can tricyclic antidepressants be used

A

they can be used at all three steps of the analgesic ladder

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8
Q

how do antidepressants work as an adjuvant drug

A

they block the reuptake of serotonin and norepinephrine to block the transmission of pain

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9
Q

what are the three things that Non Opioid analgesics are characterized by ***

A
  1. they have a ceiling effect
  2. They do not produce tolerance or physical dependance
  3. many are available without a prescription
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10
Q

what are the two categories of Non opioid analgesics

A

NSAIDS
Acetaminophen

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11
Q

What are the three major classes of NSAIDS

A
  1. Salicylates
  2. Ibuprofen/COX-1 inhibitors
  3. Cyclooxygenase COX 2 inhibitors
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12
Q

What medication is used to treat or prevent a MI***

A

ASA not Ibuprofen

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13
Q

What are NSAIDS used for***

A
  1. Anti inflammatory
  2. Analgesic
  3. Antipyretic
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14
Q

why does inflammation occur in the body***

A

upon injury cells release numerous chemicals into extracellular space (think the soup) which increases permeability of blood vessels which causes the edema

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15
Q

What do ASA and ibuprofen inhibit to prevent pain***

A

they inhibit cyclooxygenase COX synthesis

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16
Q

what is the max dose of ibuprofen in one day

A

3,200 mg/day as long as the person is over 70 kg

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17
Q

What does ASA stand for

A

Acetylsalicylic Acid

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18
Q

what is the brand name of ASA

A

aspirin

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19
Q

what COX does Aspirin block

A

ASA blocks both COX-1 and COX-2

20
Q

what COX does ibuprofen block

A

Ibuprofen blocks both COX-1 and COX-2

21
Q

what is the max dose of aspirin per day

A

max dose is 4 g per day

22
Q

how does ASA produce an antiinflammatory effect and what is an adverse effect of this***

A

ASA block the production of prostaglandins however as it is absorbed through the stomach it causes cellular damage and it also reduces the amount of protective mucus in the stomach

23
Q

what are three conditions where the antiplatelet effects of ASA are helpful

A

TIAs
Unstable angina
MI

24
Q

is ASA more effective in women or men***

A

more effective in males than females

25
Q

what are 5 adverse effects of aspirin**

A

Stomach pain
Heartburn
Nausea
Vomiting
Diarrhea

26
Q

what are 4 signs of ASA overdose ***

A

Occult bleeding (GI bleeding)
Nephrotoxicity
Hepatotoxicity
Tinnitus or hearing loss

27
Q

What pregnancy category is ASA

A

C/D

28
Q

what are the drug to drug interactions of ASA

A

any other drug that interacts with the blood can have adverse effects when paired with ASA

29
Q

What are three lab values to monitor when someone is using ASA***

A
  1. Prothrombin time
  2. INR
  3. Fasting blood glucose if diabetic
30
Q

What age group should never use ASA and why?

A

anyone under 18 should never take ASA because it increases the risk of reye’s syndrome especially if the child has just had a viral illness

31
Q

What is reyes syndrome

A

very serious condition that affects all organs in the body but mostly the brain and the liver

32
Q

Do COX-1 inhibitors have a ceiling effect

A

yes all non opioid analgesics do

33
Q

What are the adverse effects of COX-1 inhibitors

A

Gastric ulcers
GI bleeding
renal damage

34
Q

are COX-1 inhibitors acidic or basic and why is this important***

A

most are weak acids which can damage GI mucosa so you have to monitor for a GI bleed

35
Q

what are the two most important things to monitor when someone is taking NSAIDS**

A

Remember the two G’s
Kidneys (GFR)
GI bleed

36
Q

what is a more common NSAID COX-1 inhibitors or COX-2 inhibitors and why?

A

COX-1 inhibitors since COX-2 inhibitors have limited use because the increase the risk of MI or stroke

37
Q

what should NSAIDS be taken with to reduce the side effects

A

can be taken with food so they are not so hard on the stomach

38
Q

what are two main functions of Acetaminophen

A

Analgesic
antipyretic

39
Q

does acetaminophen have any anti inflammatory properties

A

NO

40
Q

does Acetaminophen cause GI bleeding

A

NO

41
Q

how does acetaminophen work to reduce a fever***

A

works directly on the hypothalamus to cause sweating and vasodilation

42
Q

which route is faster for acetaminophen rectally or PO*****

A

PO is faster than rectal

43
Q

What is the max dose of Acetaminophen in a day***

A

Max dose is 4 g per day

44
Q

what dosage of acetaminophen will no longer provide any extra analgesic affect ***

A

doses of 1,000 mg every six hours does not provide any more analgesia than 650 mg every 4 hrs the analgesia will last longer but not increase so the celing for ACET is 650 mg every 4 hours

45
Q

what is the main adverse effect of acetaminophen***

A

Liver toxicity

46
Q
A

NRSG 210 (19 decks)

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