Non-opioid analgesics

Question 1

acetaminophen/aspirin/caffeine

Excedrin

Answer 1

Purpose: treatment of mild to moderate pain or fever
Side effects: upset stomach, heartburn, depressed mood, anxious or restless feelings, insomnia

Nursing considerations

• do not give to children to teenagers with fever, flu symptoms, or chickenpox, Reye syndrome may develop
• Watch out for symptoms of stomach bleeding or liver problem

Question 2

aspirin

Answer 2

Purpose: management of mild to moderate pain or fever and TIA, prophylaxis of MI, ischemic stroke, and angina

Side effects: n/v, rash, tinnitus, GI bleeding, dyspnea

Nursing consideration:

• PO: onset 15-30 min peak 1-2 hours, duration 4-6 hours
• Rectal: onset slow, 20-60% absorbed if retained 2-4 hours
• With long-term use, check for liver daage: dark urine, clay colored stools, yellowing of skin and sclera, itching, abd pain, fever, diarrhea
• For arthritis, give 20 min before exercise, may take 2 weeks before full effect is felt
• discard tablets if vinegar-like smell
• do not give to children or teens iwth flulike symptoms or chickenpox; Reye syndrome may develop
• OTC

Question 3

celecoxib

Celebrex

Answer 3

Purpose: management of acute chornic arthritis pain, relief of primary dysmenorrheal pain within 60 minutes

Side effects: fatigue, anxiety, depression, nervousness, n/v/anorexia, dry mouth, constipation, dyspnea, back pain, tachycardia, dysuria, palpitations

Nursing considerations:

• onset: 24-48 hours, duration 12-24 hours
• can take w/o regard to meals
• do not take if allergic to sulfonamides, aspirin, or NSAIDs

Question 4

ibuprofen

Advil, Motrin

Answer 4

Purpose: treatment of mild to moderate pain, reduction of inflammation

Side effects: HA, tinnitus, nausea, anorexia, dizziness, blood dyscrasias, constipation, GI bleeding

Nursing considerations:

• Treatment of rheumatoid arthritis, osteoarthritis, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, fever
• Onset: 30 min, peak 1-2 hours
• Take with food or milk to decrease GI symptoms
• Contact provider if ringing or roaring in ears, which may indicate toxicity
• Contact provider if changes in urinary pattern, increased weight, edema, increased pain in joints, fever, or blood in urine, which may indicate kidney damage
• use sunscreen to prevent photosensitivity
• avoid use with ASA, NSAIDs, and alcohol, which ma precipitate GI bleeding
• Avoid use with anticoagulants

Question 5

naproxen

Aleve, Naprosyn

Answer 5

Purpose: treatmetn of mild to moderate pain, reudction of inflammation

Side effects: GI bleeding, blood dyscrasias, tinnitus, insomnia, vision changes, rahs, angioedema, jaundice, tachycardia, n/v/d

Nurisng considerations:

• treatment of rheumatoid, juvenile, and gouty arthritis, osteoarthritis, primary dysmenorrhea
• Patient iwth asthma, ASA hypersensitivity, or nasal polyps have increased risk of hypersensitivity
• Contact provider if black stools, flulike symptoms
• Contact provider if chnages in urinary pattern, icnreased weight, edema, increased pain in joints, fever, or blood in urine, which may indicate kidney damage
• Avoid use with ASA, steroids, and alcohol
• May icnrease risk of MI or stroke

Question 6

tramadol

Ultram

Answer 6

Purpose: management of moderate to severe pain and chronic pain

Side effects: dizziness/confusion, HA, orthostatic hypotension, abnormal ECG, visual disturbances, n/v, GI bleeding, urinary retnesion, rahs, respiratory depression

Nursing considerations:

• give with antiemetic for n.v
• take with or without food
• may cause serotonin or neuropletic malignant syndrome-like reactions
• avoid OT medications unless paroved by provider