Common Medications for Pain Management or Anesthesia Flashcards
Non Opioids
Non sedating
NSAIDS and Acetaminophen
Anti paretics (anti fever)
Anti inflammatory but NSAIDS only
Not CNS depressant
Vital signs are normal
Opioids
Sedating
CNS depressants
Low and slow vitals
No anti paretics or inflammatory properties
NSAIDS
mild to moderate pain
Naproxen #1 NSAID given
Salicylate acid (aspirin)
Acetylsalicylic acid (aspirin)
Ibuprofen and Indomethacin
Ketorolac (brand: toradol)
reduce fever, pain and inflammation
Decrease platelet aggregation
Aspirin = bleed risk
NSAID predictions
N = Not good for: GI bleeding, bad for ulcers, lungs (bad for asthma), bad for heart HTN and heart failure, kidney clogging, increased creat and Bun, Blood clot risk
Never take too NSAIDS simultaneously
use lowest dose for shortest time possible
S = Sticky blood
Increase risk for thrombosis
Bad for patients with clot history
Aspirin: no clot risk, thins blood
A = Asthma
Not safe asthma (bronchospasm) asthma and nasal polyps. Nurse should clarify order
Use acetaminophen instead of an NSAID
I = increased bleed risk
Notify HCP of any bleeding
key words = Easy bruising, tarry cool and coffee ground emesis = GI bleed
Avoid peptic ulcer (GI bleed) take medicine with food - never take on empty stomach
Avoid EGGO vitamins
Vitamin E
Gingko, Garlic
Omega 3
Increase bleeding risk
D = dysfunctional kidneys
Rental injury = long term use
Nephrotoxic, avoid renal patients
Ketorolac = kills kidneys
S = Swells the heart
CHF and worsening HTN
No NSAIDS
Ibuprofen
Do not take on an empty stomach
Patient with acid reflux on ranitidine (PPI) and NSAID yes okay
Aspirin Patient Teaching
Toxicity = Tinnitus - Report to HCP
Tachycardia and hypotension = bleeding indication
Not safe for kids - possible Reyes Syndrome
Children with viral infection (flu/varicella) = DO NOT GIVE any salicylate containing meds not even (pepto-bismol)
Best to use ibuprofen and Tylenol
Acetaminophen
Absence of bleeding, used instead of NSAIDS to decrease bleeding risk
Can be used interchangeably with NSAIDS for fever, recommended with child with food
Liver toxic - avoid ETOH
High risk client = 54 Male that abuses alcohol
Acetylcysteine
Antidote for acetaminophen
During an overdose monitor ALT and AST
Tips for Opiods
Low and slow vitals CNS depressants
Low HR, low BP, low Resp rate
Morphine sulfate
Hydromorphone
Codeine
Oxycontin
Oxycodone
Fentanyl
Opioid Adverse Affects
Low RR - reparatory depression
Hold dose for RR below 12
Low BP - hypotension
Orthostatic hypotension
Assist to a seated position
Do not get unassisted
Low brain - CNS sedation
Easily falls asleep when talking
Unarousable
Naloxone
Brand: Narcan
reversal agent for opioid and heroin overdose
1-2 hours half life
reassess every 60 minutes
Key terms:
RR below 12
Unarousable
Falling asleep while talking to you
Prepare for second dose of Narcan
Notify HCP if any of these are present
Priority Care for Naloxone
Assess ABC’s 1st
intervention: Oxygen 2nd
Make HCP aware
Second dose of naloxone
Iv Administration Opioids
2-3 minute IV push
Not over 5-10 seconds
Reassess after 15-30 minutes
Greatest risk death
Overdose and respiratory depression
Burning during push is normal
Itching is normal - treat with Benadryl
Nausea/vomiting: teach that nausea will improve with nausea. treat with antiseptics
Take PO opioids with food
Long term side effects of opioids
Low and slow GI system - take PRN stool softeners
teach preventative measures = fluid, fibre, ambulation
Don’t hold med for constipation
Greatest risk death
Overdose and respiratory depression
As well as
Advanced age
Underlying pulmonary disease (COPD, asthma)
Post surgery (24 hours)
*for questions regarding respiratory depression always choose oldest patient first or most recent surgery
