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Pharmacology 101 > Lecture 6 Nursing 100 > Flashcards

Lecture 6 Nursing 100 Flashcards

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1
Q

Pain

A

assess, intervene, drugs, review pain pathways; release of prostoglandin

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2
Q

assess pain

A

intensity, quality, location- is it moving?

not just lvl of pain- pt’s perception of pain

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3
Q

intervene

A

encourage more pain med

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4
Q

TENs

A

trans-electrical nerve stimulation

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5
Q

pain pathways neuron

A

from site of pain to brain

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6
Q

gate theory

A

stim more nerves to lessen pain

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7
Q

Non-narcotics

A

Analgesics
mildest pain relievers
non habit forming

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8
Q

Salicylates- ASA- Aspirin

A

absorbed well po
distributed widely
metabolized in the liver
excreted by kidneys

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9
Q

Salicylates

Mechanism of Actions (4)

A

Analgesia- inhibit prostaglandin synthesis
Antipyretic (fever reducer) - hypothalamic stimulation=vasodilation=diaphoresis
Anti-Inflammation - may inhibit prostaglandin synthesis & release
Anticoagulation - inhibits platelet aggregation

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10
Q

Salicylates

Therapeutic Uses

A 
mild pain relief
antipyretic
mild inflammation
reduce risk of coagulation (cardiac disease)
combined with narcotics
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11
Q

Salicylates

Drug interactions

A

many r/t highly protein bound
increases displaced drug’s effect
false urine tests

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12
Q

Salicylates- Adverse Reactions

Predictable

A

gastric distress

hearing loss with prolonged use (ringing, tinnitus)

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13
Q

Salicylates- Unpredictable Reactions

A 
Allergic reaction
Reyes Syndrome (in children; who has had viral infection)
encephalopathy- brain dysfunciton
fatty degeneration of liver
multisystem disorder
heart & kidney
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14
Q

Salicylates Nursing Implications

A 
Take with full glass of water
Check labels of OTC drugs
Do not use in children or adolescents 
Do not use prior to major surgery
Assess for HX of ulcers
Teach s/sx of bleeding
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15
Q

ParaAminophenol Derivative

A 
acetaminophen (Tylenol)
Absorbed well po
Distributed widely
Metabolized by hepatic enzymes
Excreted by kidneys & breast milk
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16
Q

ParaAminophenol Derivative

M of A

A

Analgesic- inhibit prostaglandin synthesis
antipyretic- direct action on heat; regulation center of hypothal
NO antiplatelet or anti-inflammatory effects

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17
Q

ParaAminophenol Derivative

Therapeutic uses

A

fever
muscle aches
flu
combined with narcotics

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18
Q

ParaAminophenol Derivative

Drug interactions

A

alcohol (chronic use)
barbiturates
charcoal

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19
Q

ParaAminophenol Derivative

Adverse reactions

A 
overdose- liver toxicity
coagulation defects
kidney damage
few w/ normal dosage
unpredictable: allergy
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20
Q

ParaAminophenol Derivative

Nursing Implications

A

Contradicted in pt with anemia, liver damage
read labels carefully
check OTC drugs- in many!
max dose: 4 g

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21
Q

Nonsteroidal Anti Inflammatory Durgs (NSAIDs)

A

absorbed well po
distributed widely
metabolized in liver
excreted by kidney

22
Q

NSAIDs

M of A

A

decreases inflammation and pain by inhibiting prostaglandin synthesis (mostly)
antipyretic by action to hypothal

23
Q

NSAIDs

Therapeutic Uses

A

Inflammatory response
mild to moderate pain
soft tissue injuries

24
Q

Types of NSAIDs

A

Ibuprofen - Advil, motrin, Nuprin
Indomethacin - Indocin
Napsoxen - Napsosyn
Toredol

25
Q

NSAIDs

Drug Interactions

A

wide variety r/t highly protein bound
anticoagulants (ex: coumadin)
antihypertensives

26
Q

NSAIDs

Adverse Reactions

A 
Predictable
CNS- dizzy, drowsy, HA, confusion
Eyes- blurred vision
GI - pain, bleeding, anemia
Renal - cystitis, hematuria
Unpredictable
allergic reaction like asthma
27
Q

NSAIDs

Implications

A

Contraindicated in asthma
Pain continues > 5 days call MD
Check for cross-sensitivity to ASA
May take several weeks to produce therapeutic effect
Check blood & vision before starting long term therapy

28
Q

Narcotic Opiate Agonists

A

Derived from active opium poppy
Agonist -affinity to receptor site & stimulate function
Morphine is standard of effectiveness
Demerol is synthetic narcotic

29
Q

Narcotic Opiate Agonists

Pharmacokinetics

A

Absorbed well po large first by-pass
Distributed widely
Metabolized in liver
Excreted by kidneys

30
Q

Narcotic Opiate Agonsits

M of A

A

Binds at Opiate receptor sites
Decreased pain impulse
Decreases response to pain

31
Q

Narcotic Opiate Agonists

Action Site

A 
Cough suppression
Diaphoresis & flushing
Depresses Respiration
Slow GI tract
Urine retention  (poor bladder tone)
Vassodilate>> decreases BP
32
Q

Narcotic Opiate Agonists

Therapeutic Uses

A 
Severe pain acute, chronic or terminal illness
Preoperative to decrease anxiety
Pain from MI
Schedule II 
No ceiling effect
33
Q

Narcotic Opiate Agonists

PCA

A

Patient
Controlled
Analgesia

34
Q

Codeine

A 
Mild to moderate pain
Schedule II mild - moderate pain
Antitussive- cough suprressent
Not used in chronic pain 
Has ceiling effect
35
Q

All Opiates

Drug Interactions

A

Alcohol
Sedatives
Hypnotic
Drugs that cause Resp. Depression

36
Q

Opiates

Adverse Reactions

A 
Respiratory Depression
Vasodilatation- flushing, Orthostatic Hypotension
GI- N/V, Constipation, 
Prolonged labor, depressed fetus
Allergic reactions
Kidney dysfunction
37
Q

Opiates

Nursing Implications

A 
Hold if resp. rate 8-10/min
Check for Urinary retention
Check peristalsis
Assess pain with each dose
Administer before pain is severe
Double locked, signed out of controlled drugs
counted each shift, witness any waste
Assess tolerance and increase dose prn
38
Q

Narcotic Antagonist

A 
Naloxone (Narcan)
Competes with agonist at receptor sites
Usually IV or IM
Rapid onset, duration 2-3 min.
May need to repeat dose
39
Q

Narcotic Antagonist Uses

A

Narcotic OD

Reverse respiratory depression

40
Q

Narcotic Antagonist

Adverse Reactions

A

Nausea/Vomiting
Hypertension
Tachycardia
Hyperventilation

41
Q

Narcotic Antagonist

Nursing Implications

A

Use cautiously with cardiac irritability

Safe to use when cause resp. depression unknown

42
Q

Activity Thread: Skeletal Muscle relaxants

A 
Treat acute painful conditions with:
muscle spasticity
multiple sclerosis
cerebral palsy
CVA
spinal cord injury
43
Q

Central Acting Skeletal Muscle relaxants

A

go to CNS and depress it from sending impulses to contract muscle
synergic- multiplies rapidly
act in spinal cord
use with rest and PT

44
Q

Central Acting relaxants

Interactions

A

Synergetic Effect with other CNS depressants
Added depression with ETOH
MAO inhibitors, psychiatric antidepressants
Antihypertensives (have less effect)
Cholinergic blockers (increase anticholinergic effect-dry mouth, urinary retention)

45
Q

Central Acting relaxants

Adverse Reactions

A

Drowsiness, dizziness
N/V/D abd. distress, constipation
Resp depression, hypotension

46
Q

Central Acting relaxants

Nursing Implications

A

Warn to not drive or use machinery
Avoid ETOH, CNS depressants
caution with Hx. urine retention, cardiac disease
not to pt with glaucoma

47
Q

Peripherally Acting Muscle Relaxants

A

dantrolene (Dantrium) - similar effect to central acting Rx
Works directly on muscle contractile mechanism
inhibits Ca release from muscles
Used with all types of spastically
Interact with CNS depressants

48
Q

Peripherally Acting relaxants

Adverse Reactions

A 
muscle weakness
lightheadedness
visual and speech disturbances
urine retention, frequency or incontinence
Idiosyncratic reaction = hepatitis
49
Q

Peripherally Acting

Nursing implications

A

Not for use in pt with liver dysfunction
Caution in cardiac or lung dysfunction
Warn pt about weakness, drowsiness, dizziness
Obtain baseline of liver function

50
Q

Other Skeletal Muscle relaxants

A

Benzodiazepines – diazepam (Valium)
Drug of choice for treatment of spasms
Enhances neurotransmitter GABA (gamma aminobutyric acid)
inhibitory effect on muscle contraction
Limited by CNS effects & tolerance development

Pharmacology 101 (15 decks)

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