Meds for pain and inflammation

Question 1

NSAIDs inhibit

Answer 1

cyclooxygenase (COX) 1 and 2

Question 2

COX-1 makes

Answer 2

protective prostaglandins and thomboxanes

Question 3

COX-2 makes

Answer 3

protective prostaglandins and inflammatory PGs

Question 4

basically NSAIDs can

Answer 4

prevent inflammation, platelet aggregation, decrease gastric mucosa protection, affect blood vessels (constriction and dilation)

Question 5

First generation NSAIDs non specific COX inhibitors - 7

Answer 5

aspirin
ibuprofen (Motrin)
naproxen (Naprosyn)
indomethacin (Indocin)
diclofenac (Cataflam)
ketorolac
meloxicam (Mobic)

Question 6

Second generation NSAIDs selective COX-2 inhibitor

Answer 6

celecoxib (Celebrex)

Question 7

salicylism (tinnitus, sweating, headache, respiratory alkalosis) may occur with

Answer 7

aspirin

Question 8

aspirin is contraindicated in children due to

Answer 8

possibility of Reye syndrome

Question 9

GI distress and damage to mucosa are adverse effects to using NSAIDs, what could you do for a client with these symptoms?

Answer 9

administer PPI such as omeprazole (Prilosec) or an H2 receptor agonist such as ranitidine (Zantac)

Question 10

celecoxib may be contraindicated in clients who have known

Answer 10

CV disease

Question 11

_____ slows the production of prostaglandins in the CNS

Answer 11

acetaminophen (Tylenol)

Question 12

clients are advised to take no more than __/day of acetaminophen and t monitor for signs of

Answer 12

4g, hepatotoxicity

Question 13

the antidote for acetaminophen is

Answer 13

acetylcysteine (Mucomyst)

Question 14

opioids act on receptors in the central nervous system which can cause what effects?

Answer 14

analgesia, respiratory depression, euphoria, sedation, decreased GI motility

Question 15

the main meds that are opioid agonists: 6

Answer 15

morphine
fentanyl (Sublimaze)
meperidine (Demerol)
methadone (Dolophine)
codeine
oxycodone (OxyContin)

Question 16

antidote for opioids

Answer 16

naloxone (Narcan)

Question 17

opioid overdose triad of coma, respiratory depression and pinpoint pupils, what is the nursing intervention?

Answer 17

monitor VS, provide mechanical ventilation, administer naloxone

Question 18

meperidine is contraindicated in clients who have renal failure because

Answer 18

accumulation of normeperidine which can result in seizures and neurotoxicity

Question 19

agonist/antagonist opioid used to treat opioid dependence

Answer 19

buprenorphine

Question 20

agonist/antagonist opioid used for labor pain

Answer 20

butorphanol

Question 21

agonist/antagonist opioids as compared to opioid agonists

Answer 21

low potential for abuse (little euphoria), less respiratory depression, less analgesic effect

Question 22

relieves severe opioid induced constipation

Answer 22

methylnaltrexone

Question 23

used with a primary pain med, usually an opioid agonist, to increase pain relief while reducing the dosage of the opioid

Answer 23

adjuvant meds

Question 24

Adjuvant meds for pain

TCAs 2

Answer 24

amitriptyline (Elavil)

imipramine (Tofranil)

Question 25

Adjuvant meds for pain | anticonvulsants 3

Answer 25

cabamazepine (Tegretol) gabapentin (Neurontin) phenytoin (Dilantin)

Question 26

Adjuvant meds for pain | CNS stimulants 2

Answer 26

methylphenidate (Ritalin) | dextroamphetamine (Dexedrine)

Question 27

Adjuvant meds for pain | antihistamine

Answer 27

hydroxyzine (Vistaril)

Question 28

Adjuvant meds for pain | glucocorticoids 2

Answer 28

dexamethasone (Decadron) | prednisone (Deltasone)

Question 29

Adjuvant meds for pain | biphosphonates 2

Answer 29

etidronate (Didronel) | pamidronate (Aredia)

Question 30

Adjuvant meds for pain | NSAIDs 2

Answer 30

ibuprofen (Motrin) | ketorolac (Sprix)

Question 31

as adjuvant meds for pain, NSAIDs treat

Answer 31

inflammation

Question 32

as adjuvant meds for pain, TCAs treat

Answer 32

depression, and neuropathic pain such as cramping, burning, darting and lancinating pain

Question 33

as adjuvant meds for pain, anticonvulsants treat

Answer 33

neuropathic pain

Question 34

as adjuvant meds for pain, CNS stimulants augment

Answer 34

analgesia and decrease sedation

Question 35

as adjuvant meds for pain, antihistamines decrease

Answer 35

anxiety, prevent insomnia, relieve nausea

Question 36

as adjuvant meds for pain, glucocorticoids decrease

Answer 36

pain from intracranial pressure and spinal cord compression

Question 37

as adjuvant meds for pain, biphosphonates manage

Answer 37

hypercalcemia and bone pain

Question 38

how can decreased bowel motility be counteracted in patients experiencing anticholinergic effects due to pain meds?

Answer 38

administer stimulant laxative, such as bisacodyl (Dulcolax) for decreased motility and docusate sodium (Colace) for constipation