Drug Cards- Pain & Paralytics

Question 1

Acetaminophen (brand name)
Class:
action:
indications:
contraindications:
dosage:
route:
how often:

Answer 1

Acetaminophen (Tylenol)
Class: analgesic, antipyretic
action:
indications: mild-moderate pain, fever, when aspirin isn't tolerated
contraindications: <3 yo
dosage: 325-650 mg
route: PO/PR
how often: 4-6 hrs

Question 2

Succinylcholine (brand name)
Class: 
action/description: 
indications: 
contraindications/ precautions 
dosage/route

Peds: dosage, route

Answer 2

Succinylcholine (Anectine)
Class: Depolarizing neuromuscular blocker
action/description: It’s an ultra-short-acting depolarizing neuromuscular blocker.
indications: Facilitated endotracheal intubation .
contraindications: Family history of malignant hyperthermia , penetrating eye injury, narrow-angle glaucoma
Precautions: Severe burn or crush injury; electrolyte imbalances; hepatic, renal, cardiac, or pulmonary impairment; fractures; spinal cord injury; dehydration; severe anemia; porphyria .
dosage/route: 1-1.5 mg/kg IV/IM

Peds: dosage, route: 1-2 mg/kg IV/IM

Question 3

Vecuronium (brand name)
Class: 
action/description: 
indications: 
contraindications
precautions 
dosage: 
route: 

Peds: dosage, route

Answer 3

Vecuronium (Norcuron)
Class: Nondepolarizing skeletal muscle relaxant
action/description: It’s a nondepolarizing skeletal muscle relaxant similar to pancuronium with minimal cardiovascular effects.
indications: Facilitated endotracheal intubation .
contraindications: none
precautions: Hepatic or renal impairment, impaired fluid and electrolyte or acid-base balance, severe obesity, myasthenia gravis, elderly, debilitated patients, or malignant hyperthermia
dosage: 0.08-0.1 mg/kg
route: IV

Peds: dosage, route: same

Question 4

Fentanyl (Brand name) 
Class: 
action/description: 
indications: 
contraindications/ precautions 
dosage/route

Peds: dosage, route

Answer 4

Fentanyl (Sublimaze)

Class: narcotic analgesic.

Action/description: It’s a potent synthetic narcotic analgesic similar to morphine and meperidine but with a more rapid and less-prolonged action.

indications: Induce sedation for endotracheal intubation. .
contraindications: MAO inhibitors within 14 days, myasthenia gravis.

Precautions: Increased intracranial pressure, elderly, debilitated, COPD, respiratory problems , hepatic and renal insufficiency.

dosage/route: 25-100 µcg slow IV (2-3 min)

Peds: dosage, route: 2µcg/kg slow IV/IM

Question 5

Hydromorphone (brand name)
Class: 
action/description: 
indications: 
contraindications
precautions 
dosage: (3)
route: (3)

Peds: dosage, route

Answer 5

Hydromorphone (Dilaudid)

Class: Narcotic, analgesic, antitussive.

Action/description: It’s an opioid agonist that binds to several opioid receptors. Its analgesic characteristics are through its effect on the mu-opioid receptors. It also acts centrally at the level medulla, depressing the respiratory drive and suppressing cough.

indications: relief of moderate to severe pain and control of persistent nonproductive cough .
contraindications: Intolerance to opiate agonist, acute bronchial asthma, COPD, upper airway obstruction, severe respiratory depressions, pregnancy

Precautions: -

dosage/route: “PO tablet: 2,4,6,8 mg
Oral solution: 5mg/5 mL
Injection: 1 mg/mL 10 mg/mL”

Peds: dosage, route: - none specified

Notes- Nursing Implications : Note baseline RR rate, depth, rhythm, size of pupils. 12 RR/min or less sign of toxicity . withhold drug contact AP. Monitor VS at · regular intervals, assess effectiveness 30 mins after dose. Monitor bowel habits.as may cause constipation ,

Question 6

Morphine sulfate (brand name)
Class: 
action/description: 
indications: 
contraindications
precautions 
dosage/route (3)

Peds: dosage, route (2)

Answer 6

morphine sulfate (morphine)

Class: Narcotic, analgesic

Action/description: It’s a potent analgesic and sedative that causes some vasodilation, reducing venous return, and reduced myocardial oxygen demand

indications: Moderate to severe pain and in MI and to reduce venous return in pulmonary edema.
contraindications: Hypersensitivity to opiates, undiagnosed head or abdominal injury, hypotension, or volume depletion, acute bronchial asthma, COPD, severe respiratory depression, or pulmonary edema d/t chemical inhalation.

Precautions: Elderly, children, or debilitated patients. Naloxone should be readily available to counteract the effects of morphine.

dosage/route: “Pain
2.5-15 mg IV
5-20 mg IM/SQ

AMI or PE
1-2 mg/ 6-20 min to response “

Peds: dosage, route: “0.05-0.1 mg/kg IV

0.1-0.2 mg/kg IM/SQ”

Question 7

Ketorolac (brand name)
Class: 
action/description: 
indications: 
contraindications
precautions 
dosage/route 

Peds: dosage, route

Answer 7

Ketorolac (Toradol)

Class: NSAID

Action/description: an injectable NSAID that exhibits analgesic, antiinflammatory, and antipyretic properties without sedative effects.

indications: Mild/moderate pain
contraindications: Hypersensitivity to ketorolac, aspirin, or other NSAIDs, and asthma

Precautions: Peptic ulcers, renal or hepatic impairment, or elderly.

dosage/route: 30 mg IV/IM (15 mg > 65 yrs or weighs < 50 kg)

Peds: dosage, route: none specified

Question 8

Nitrous oxide (brand name)
Class: 
action/description: 
indications: 
contraindications
precautions 
dosage/route 

Peds: dosage, route

Answer 8

Nitrous oxide (Nitronox)

Class: Analgesic (gas)

Action/description: it’s a self-administered analgesic gas composed of 50% oxygen and 50% nitrous oxide. Its effects last only 2 - 5 min s/p administration ceases.

indications: Musculoskeletal, bum, and ischemic chest pain and severe anxiety (including hyperventilation).
contraindications: Possible bowel obstruction, pneumothorax or tension pneumothorax, COPD, head injury, impaired mental status, or drug intoxication.

Precautions: Use in well-ventilated area. It may cause nausea and vomiting.

dosage/route: It is self-administered inhalation until the pain is relieved or the patient drops the mask .

Peds: dosage, route: none specified