pain and inflammation Flashcards
therapeutic index
level of medication in someones plasma. highest levels that effective
half life
how long it takes for half med to get out of body
onset
when medication kicks in
peak
highest level of medication in body
duration
how long is last in body
non-opioid analegesics
nonsteriodial anti inflammatory drugs –> cox-1 and cox-2 inhibitors –> selective cox-2 inhibitors
acetaminophen (tyenol)
acetaminophen mechanism of action
- inhibits cycloxygenase interfering with the pain impulse generation in the pns
- acts on the temperature regulating center in the brain
acetaminophen routes, onset, peak, duration
Routes: PO, PR, IV
Onset: varies
Peak: 1-3 hours
Duration: 3-4 hours
acetaminophen complication, contraindications, interactions
complications
- acute toxicity- liver damage
- nursing actions for toxicity
contraindication
- hypersensitivity, severe liver kidney impairment, chronic alcohol use or malnutrion
interactions
- alcohol, warfarin (increase risk for bleeding
acetaminophen medication administration implications, client teaching, evaluation
implication:
- should not exceed 4g/day, less if positive risk factors for complication
- should not be taken for more than 10 days
client teaching
- look for signs and symotms of bleeding
- internal bleeding, bruising, blood in stool, coffee grind throw up, gums bleeding, nose bleeding
evaluation
- reevaluate pt’s pain or fever at time of onset; they should be reduced
nonsteroidal anti-inflammatory drugs mechanism of action
- inhibits of cyclooxygenase- cox-1 inhibition: decrease platelt aggregation and kidney damage
- cox-2 inhibitors: decrease inflammation, fever and pain and does not decrease platelet aggregation
NSAID medications
- asprin
- ibuprofen
- naproxen
- indomethacin
- diclofenac
- ketorolac
- meloxicam
amber itches nose in dcotor kaits medicine
cox-2:
- only inhibitors- celecoxib
NSAIDS routes, onset, peak, duration
routes: PO, PR, IV
onset: depens upon route: 5min- 1 hour
peak: unknown- 4 hours
duration: 1-8 hours depending on the medication
NSAIDS therputic uses
inflammation suprresion, analgesia, fever reduction, inhibition of platelet aggregation (only inhibitor)
NSAID complications, contraindications,interactions
complications
- GI discomfort
- impaired kidney function
- salicylism/ aspirin toxicity (asprin only)
- reye’s syndrome (rare)
contraindications
- bleeding disorders/ peptic ulcer disease
- pregnancy cat D
- advanced kidney disease (Ketoorlac only)
- sulfonamides allergy (celecoxib only)
interaction
- anticoagulants
- glucocorticoids
- alcohol
- other nsaids
- fever, garlic, ginger, ginkgo
NSAIDS implications
- must take NSAID with food, milk, or 8oz of water- to avoid gi irritation
- no crushing or chewing enteric coated or sustained release asprin tablets
- monitor for complication
- ketorolac specific: do not rise for more then 5 days because of kidney damage, the risk with opioids to allow for the lower opioid dosage to minimize side effects and monitor kidney function
- total daily dosage for ibeprofen= 2400mg
client teaching
- do not use with other nsaids
- avoid alcohol while taking NSAIDS
- educate s/s of bleeding
- take with food
- no aspirn for children who have viral infections
opioid agonists moa
- activates Mu and Kappa receptors producing analgesia, respiratory depression, euphoria, sedation, decreased gi motility
- linked to physical dependence
common opoid agonists medications
- morphine
- fentanyl
- meperidine
- methadone
- codeine
- oxycodone
- hydromorphone
opioid agonists routes, onset, peak, duration, half life
routes: PO, SQ, IM,PCA, Epidural, intrathecal (morphine only), tramucosal/transdermal (fentanyl only), rectal (oxycodone only)
onset: depends on route 5-60 min
peak: unkown-2 hours
Duration: 4-24 hours
half life: 1.5-7 hours
opioid agonists theraputic uses
- relief of moderate to sever pain
- sedation
- education of bowel motility
- cough suppression (Codeine)
opioid agonists complications
- respiraotry depression
- constipation
- orthostatic hypotension
- urinary retention
- sedation
- nausea/ vomiting
- opioid toxic traid
opioid agonists contraindication
- pregnancy cat c
- biliary tract surgery
- preemies during/after delivery
- kidney failure (memperidine only)
- head injuries
- extremely obese
- hepatic or renal disease
- hypotension
opioid agonists interactions
- other cns depressants
- anticholinergic agents
- antihypertensive
- alcohol
