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NUR 325 > Exam 1 Medication > Flashcards

Exam 1 Medication Flashcards

1
Q

Types of analgesics

A

NSAIDs (1st and 2nd gen), acetaminophen, opioids, centrally acting nonopioids

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2
Q

COX (Cyclooxygenase)

A

produces inflammatory response

enzymes convert arachidonic acid into prostaglandins and other compounds

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3
Q

COX-1

A

homeostasis

protects gastric mucosa, enhance platelet aggregation, promotes renal function

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4
Q

COX-2

A

response to injury

inflammation, pain, fever

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5
Q

1st gen NSAID Pharm Action

A

COX-1 and COX-2 inhibitor
decrease: pain, inflammation, temp
anticoagulant, impairs renal perfusion, gastric mucosa not protected

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6
Q

Types of 1st gen NSAIDs

A

aspirin (ASA), ibuprofen (Advil, Motrin), naproxen, aleve, indomethacin, ketorolac

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7
Q

1st gen NSAIDs ADR

A

gastric upset, heartburn, nauseas, gastic ulcers, bleeding tendencies, renal dysfunction, Reye’s syndrome (swelling in liver and brain in kids after viral infection)

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8
Q

1st gen NSAIDs Interventions

A

monitor s/s of bleeding and easy bruising petechiae,
may need to use proton pump inhibitor,
monitor I&O,
do labs: BUN and creatine,
monitor tinnitus, dizzy, headache
abd pain, hematemesis, coffee-ground emesis
red, black or tar stool

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9
Q

1st gen NSAIDs Admin

A 
swallow whole (enteric-coated or SR)
stop 1 week before surgery
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10
Q

1st gen NSAIDs Client Instructions

A 
take w/ food or milk
avoid alcohol
report s/s bleeding
changes in urination
sudden weight gain, edema
stop taking if: ringing in ears, dizzy, unwarranted sweat
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11
Q

1st gen NSAIDs Contraindication/Precaut

A

pregnancy, peptic ulcer disease, bleeding disorder, pre-op, older adults, ETOH abuse, H. pylori, HTN, kids w/viral infection, heart fail, renal dysfunc

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12
Q

1st gen NSAIDs Interactions

A

aspirin and anticoagulants (both incre bleed), aspirin and NSAID, ACE inhibitors (both incre renal dysfunc)

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13
Q

2nd Gen NSAIDs name

A

celecoxib (Celebrex)

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14
Q

2nd Gen NSAIDs Pharm Action

A

COX-2 inhibitor, suppress pain inflammation and fever, decrease gastric effects, increase risk for CV issues (vasoconstrictor and platelet aggregation)

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15
Q

2nd Gen NSAIDs Intervention

A 
monitor s/s of GI bleed
may need proton pump inhibitor 
monitor I&O
monitor lab: BUN, creatine
monitor s/s for MI (left arm hurt, impending doom, jaw pain) and CVA (slur speech, face droop)
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16
Q

2nd Gen NSAIDs Client Instructions

A

take a w/low dose of ASA, and food or milk
avoid alcohol
report s/s GI bleed
changes in urination
sudden weight gain
report: chest pain, short of breath, severe headache, s/s stroke
give 2 hours away from Mg or Al antacids

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17
Q

2nd Gen NSAIDs Contraindication/Precaut

A

pregnancy, kidney or liver impairment, GI bleeds, anemia, ETOH abuse, asthma

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18
Q

2nd Gen NSAIDs Interactions

A

Lasix (decre the diuretic effect of Lasix), fluconazole (can incre its levels), anticoagulants (both)

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19
Q

Acetaminophen Pharm Action

A

nonopioid analgesic (mild to moderate pain), COX inhibitor, fever reducer,

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20
Q

Acetaminophen ADR

A 
liver damage (if take too much)
HTN (mainly in women or those taking it daily)
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21
Q

Acetaminophen Admin

A

can be given oral, rectal, IV

max 4g per day

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22
Q

Acetaminophen Interventions/Client Instructions

A

avoid more than 4g a day
report/monitor: abd discomfort, N/V/D, sweating
take BP

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23
Q

Acetaminophen Contraindication/Precau

A

ETOH abuse

use w/ caution: anemia, hepatic or renal disease, immune suppression (may mask infection)

24
Q

Acetaminophen Interactions

A

alcohol

warfarin (incre risk of bleed)

25
Q

Centrally Acting Nonopioid name and pharm action

A

tramadol (Ultram), for moderate to moderately severe pain

binds to select opioid receptors, blocks reuptake of norepinephrine and serotonin

26
Q

Centrally Acting Nonopioid ADR

A

sedation, dizzy, headache, nausea, constipation, seizure, urine retention

27
Q

Centrally Acting Nonopioid Interventions

A

monitor ambulation (dizzy)
give w/food and antiemetic (nausea)
measure VS and give opioid antagonist when RR falls
Monitor s/s seizures, have suction equipment ready
monitor for urinary retention
fluid, fiber, movement (constipation)

28
Q

Centrally Acting Nonopioid Admin

A

onset is 1 hr (give before pain is high level)

ER so swallow whole

29
Q

Centrally Acting Nonopioid Client Instructions

A

Avoid before driving
Sit if lightheaded/change positions slowly
fluid, fiber, movement when constipated
Only take PRN

30
Q

Centrally Acting Nonopioid Contraindication/Precau

A

acute ETOH, opioids, psychotics drugs (both depress)
seizure disorder
respiration depression

31
Q

Centrally Acting Nonopioid Interactions

A

MAOIs risk for hypertensive crisis
SSRI
Tricyclic antidepressants
CNS depressants

32
Q

Opioid Agonist vs Opioid Agonist-Antagonist

A

increase response, mimic action of natural opioids

decrease mu and increase kappa

33
Q

Opioid Agonist types

A

morphine, fentanyl, demerol, methadone

34
Q

Opioid Agonist Pharm action

A

analgesia

binds with mu receptor

35
Q

Opioid Agonist ADR

A

respiration depression, sedation, dizzy, lighthead, drowsy, constipation, N/V, euphoria, risk for abuse

36
Q

Opioid Agonist Interventions

A 
monitor VS/RR (give opioid antagonist if RR too low)
monitor during ambulation
monitor bowel function
hydration, encourage urination 
lowest dose, short term
37
Q

Opioid Agonist Admin

A

get VS before
oral, IM, IV, subcut, rectal, epidural
swallow whole SR
IV slow push 4-5 min

38
Q

Opioid Agonist Client Instructions

A

only take PRN
do not drive
get up slow/slow position change
incre fluid, fiber, activity

39
Q

Opioid Agonist Contraindication/Precau

A

pregnancy, renal failure, careful admin to old and young

40
Q

Opioid Agonist Interactions

A

CNS depressants
anticholinergics (both urine retention)
anti-hypertensives (both incre BP)

41
Q

Opioid Agonists-Antagonists names

A

butorphanol and pentazocine (Talwin)

42
Q

Opioid Agonist-Antagonist Pharm Action

A

analgesic

mu antagonist, kappa agonist

43
Q

Opioid Agonists-Antagonists ADR

A

respiration depression, sedation, dizzy, ligthead, headache, nausea, inre cardiac workload, abstinence syndrome (withdrawal)

44
Q

Opioid Agonists-Antagonists Interventions

A

ask about opioid use
monitor VS
monitor ambulation
do not give to MI or cardiac insufficiency

45
Q

Opioid Agonists-Antagonists Admin

A

IM, IV, intranasal, oral
measure VS
don’t discontinue abruptly

46
Q

Opioid Agonists-Antagonists Client Instructions

A 
take PRN, short term
don't drive
caution when changing positions 
don't take with w/opioid 
don't use for heart pain
47
Q

Opioid Agonists-Antagonists Contraindication/Precau

A

acute MI, cardiac sufficient
opioid dependency
history of drug abuse

48
Q

Opioid Agonists-Antagonists Interactions

A

CNS depressants

opioids (decre effects)

49
Q

Opioid Antagonists name and Pharm Action

A

naloxone (Narcan)
block opioid receptors
reverse effects of opioids

50
Q

Opioid Antagonists ADR

A 
ventricular arrhythmias
abstinence syndrome 
HTN
vomit
tremor
51
Q

Opioid Antagonists Intervention

A

monitor BP, VS, heart rhythm

52
Q

Opioid Antagonists Admin

A 
IM, IV, subcut
IV: monitor VS every 5 min
effects last 60-90 mins
respiratory depression and pain can occur
prepare to give every 2-3 mins
53
Q

Opioid Antagonists Client Instructions

A

warn them of ADR and pain

54
Q

Opioid Antagonists Contraindication/Precaut

A

opioid dependent
respiratory depression not from opioid
caution w/cardiac irritability and seizure

55
Q

Opioid Antagonists Interactions

A

decrease opioid effect

NUR 325 (2 decks)

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