DRUGS AND HOW THEY WORK Flashcards
opioids action
-blocking receptors in the CNS, when those receptors are blocked, the perception of pain is blocked
-Bind to receptors in the spinal cord, thus blocking the release of neurotransmitters involved in pain transmission.
Suppress the Central Nervous System
opioids rationales for use
Used for the treatment of moderate to severe pain.
opioids prototype
morphine – meperidine(Demerol) codeine hydromorphone(Dilaudid) – fentanyl(Duragesic) oxycodone(+ acetaminophen = Percocet) Hydrocodone(+acetaminophen= Vicodin)
opioids therapeutic effects
alleviate moderate to severe pain, reduce cough, relieve diarrhea and induce anesthesia
opioids adverse effects
CNS depression ◦Respiratory depression ◦Disorientation ◦Sedation Constipation Nausea and vomiting Pruritis (itching) Urinary retention
opioids assessments before giving
Allergies Alcohol use Pain level Level of consciousness Vital signs
opioids teaching
For patients on long term opioids, instruct on ways to counteract the side effects of constipation
opioids successful outcomes
Patient will report decreased or no pain
acetaminophen action
causes pain impulses to be blocked peripherally, in response to the inhibition of prostaglandin synthesis.
acetaminophen rationales for use
To lower temperature (fever) and to relieve mild to moderate pain
acetaminophen prototype
abenol ,acephen, APAP, aspirin free anionic, cetafen, feverall, infantaire, little fevers, mapap, nortemp children, ofirmev, pain eze, silapap, silapap, silapap infants, tylenol, valorin
acetaminophen therapeutic effects
analgesia, antipyresis
acetaminophen adverse effects
Liver toxicity with an over dosage or frequent ingestion of large amounts over time
- rash
- nausea
- vomiting
- blood disorders or dycrasias (anemias)
- hepatotoxicity and nephrotoxicities
acetaminophen assessment before giving
- overall health status
- alcohol usage
- self-medication: amt, frequency and type of drugs taken (esp with OTC drugs)
- assess type, location and intensity of pain
- assess fever, not signs of: diaphoresis, tachycardia, and malaise
- elvatuate hapatic, hematologic and renal function
acetaminophen teaching
- Don’t take with alcohol
- Follow the package dosaging instructions
acetaminophen successful outcomes
- relief to mild to moderate pain
- reduction of fever
aspirin action
Inhibit the synthesis of prostaglandins
aspirin rationales for use
for the treatment of mild to moderate pain, fever, or inflammation; also as prevention for strokes and heart attacks
aspirin prototype
ascriptin, aspercin, aspergum, aspirtab, bayer aspirin, bufferin, easprin, ecotrin, genacote, halfprin, healthprin, ZORprin
aspirin therapeutic effects
analgesia. reduction in inflammation. reduction of fever.prevention for strokes and heart attacks
- antipyretic
- non-opioid analgesics
aspirin adverse effects
- bleeding tendencies
- gastrointestinal irritation
- Renal side effects
aspirin assessment before giving
- check for allergies
- assess for pain
- monitor hepatic function
aspirin teaching
- Instruct patients to take aspirin with milk or food.
- Stress importance of following the prescription label instructions
- Monitor for GI symptoms or signs of bleeding
- No aspirin for children under the age of 18 due to the risk of Reye’s syndrome
aspirin successful outcomes
- relief of mild to moderate discomfort
- increased ease of joint movement
- reduction of fever
- prevention of transient ischemic attacks
- prevention of MI
muscle relaxants action
reduction of muscle spasm
muscle relaxants rationale for use
relief of painful musculoskeletal conditions such as muscle spasm
muscle relaxants prototype
baclofen (lioresal) cyclobenzaprine (flexeril) carisoprodol (soma) chlorzoxazone (paraflex) metaxalone (skelaxin) methocarbamol (robaxin) tizanidine (zanaflex)
muscle relaxants therapeutic effects
skeletal muscle relaxants( centrally acting)
muscle relaxants adverse effects
euphoria, lightheadedness, dizziness, drowsiness, fatigue, confusion, and muscle weakness
less common: GI upset, headache, slurred speech, muscle stiffness, constipation, sexual difficulties in males, hypotension, tachycardia and weight gain
muscle relaxants assessment before giving
- complaints of insomnia
- time it takes to fall asleep and energy level when they wake up
- difficulties sleeping
- vital sign (BP)- both supine and standing measurements
- pulse rate and rhythm
- presence of pain
- head to toe assessment
- use of alcohol
- smoking history
- past and current use of meds
- changes in health status
- level of orientation
- mood changes
- depression or other mental disorders
muscle relaxants teaching
- keep drugs out of reach from children
- always check with the prescriber or pharmacists before taking any over-the-counter medication
- take med as prescribed
- avoid driving or any activity that involves mental alertness
- do not abruptly discontinue or withdraw these medication
- hangover effects may occur
- avoid smoking in bed or when lounging
- teach about drug/drug and drug/food interaction
- effect of grapefruit or grapefruit juice on benzodiazepines
muscle relaxants successful outcomes
- decrease spasticity
- reduction of choreiform movements in Huntington’s chorea
- decrease rigidity in parkinsonian syndrome
- relief of pain from trigeminal neuralgia
NSAIDS action
- Block formation of prostaglandins
- Suppress the hypothalamus
- Reduce platelet aggregation and tissue permeability
- All leading to their anti-inflammatory, analgesic and antipyretic effects
NSAIDS rationales for use
have analgesic, anti-inflammatory, and antipyretic (anti-fever) activity, used for mild to moderate pain, headaches , fever and inflammatory disorders like arthritis
NSAIDS prototype
- ibuprofen (Motrin)
- naproxen (Naprosyn)
- ketorolac(Toradol) -Only NSAID that can be given parenterally
- Cox –2 inhibitors:
- celecoxib(Celebrex
NSAIDS therapeutic effects
Mild to moderate pain, headaches
Fever
Inflammatory disorders like arthritis (rheumatoid, juvenile and osteoarthritis, ankylosing spondylitis)
treatment of gout and hyperuricemia
NSAIDS adverse effects
- bleeding tendencies
- gastrointestinal irritation
- Renal side effects
NSAIDS assessments before giving
perform a head-to-assessment
measure vitals
take med history
check lab results reflecting hematologic, renal and hepatic functioning
NSAIDS teaching
Instruct patients to take these medications with milk or food.
Assess for GI complaints and for bleeding symptoms.
Don’t takewith aspirin
Tell physician that they are taking this type of medication.
Follow the label instructions and don’t exceed the daily dosage
NSAIDS successful outcomes
decrease in acute pain, decrease in swelling, pain, stiffness, and tenderness of joint or muscle area; improved ability to perform ADLs; improve muscle grip and strength, reduction in fever; return to normal lavatory values for CBC and sedimentation rate; and return to a less inflamed state as evidenced by improved sedimentation rates, radiographic examination, computed tomographic scan or magnetic resonance imaging.
