Pain

Question 1

Aspirin - Class & MOA

Answer 1

• Class: Anti-inflammatory: Salicylates
• MOA: dcr inflammation & platelet aggregation (non-selective Cox inhibitor; irreversible inhibits Cox-1)

Question 2

Aspirin - Indications

Answer 2

• Mild pain
• Inflammation
  > high dose: 325-650mg PO PRN
• Anticoagulation (platelet inhibitor) for CVD
  > low dose: 81mg or 325mg PO daily)

Question 3

Aspirin - Contraindications & AEs

Answer 3

• Contra: viral illness in children (Reye syndrome)
• AEs:
  > easy bruising
  > N/V
  > gastritis/epigastric pain
  > peptic ulcers
  > UGI bleeding

Question 4

Aspirin - Nursing Considerations

Answer 4

• Hold 1 week prior to procedures/surgery
• Teach:
  > take as prescribed
  > take w/ food
  > full glass of water (8oz)
  > report GI pain &/or dark/bloody stools
  > monitor H/H if UGI bleed

Question 5

Salicylate (Aspirin) Toxicity

Answer 5

• Risk: greater than 4g/day
• Tinnitus &/or hearing loss (1st sign)
• dizziness, drowsiness
• tachycardia
• hypoglycemia
• excessive sweating
• metabolic acidosis
• Nurse: stop admin of drug, evaluate CNS, monitor: CBC, renal & liver labs
• Severe tx: dialysis

Question 6

Fentanyl - Class & Use

Answer 6

• Class: Opioid Agonist
• Use: acute & chronic pain, adjunct to general anesthesia

Question 7

Fentanyl - Dose/Route Considerations

Answer 7

• IV: onset: 1min, peak: 3-5min, duration: 30-60min
  > common dose: 50mcg q1-2hrs PRN
  > comminly used in PCA pumps
  > deliver over 4-5mins
• Transdermal: half-life 13-22hrs
  > common dose: 25mcg/hr
  > change patch every 72hrs