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pharm > pain and inflammation > Flashcards

pain and inflammation Flashcards

1
Q

therapeutic index

A

level of medication in someones plasma. highest levels that effective

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2
Q

half life

A

how long it takes for half med to get out of body

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3
Q

onset

A

when medication kicks in

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4
Q

peak

A

highest level of medication in body

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5
Q

duration

A

how long is last in body

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6
Q

non-opioid analegesics

A

nonsteriodial anti inflammatory drugs –> cox-1 and cox-2 inhibitors –> selective cox-2 inhibitors

acetaminophen (tyenol)

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7
Q

acetaminophen mechanism of action

A
  • inhibits cycloxygenase interfering with the pain impulse generation in the pns
  • acts on the temperature regulating center in the brain
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8
Q

acetaminophen routes, onset, peak, duration

A

Routes: PO, PR, IV
Onset: varies
Peak: 1-3 hours
Duration: 3-4 hours

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9
Q

acetaminophen complication, contraindications, interactions

A

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

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10
Q

acetaminophen medication administration implications, client teaching, evaluation

A

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

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11
Q

nonsteroidal anti-inflammatory drugs mechanism of action

A
  • 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
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12
Q

NSAID medications

A
  • asprin
  • ibuprofen
  • naproxen
  • indomethacin
  • diclofenac
  • ketorolac
  • meloxicam
    amber itches nose in dcotor kaits medicine

cox-2:
- only inhibitors- celecoxib

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13
Q

NSAIDS routes, onset, peak, duration

A

routes: PO, PR, IV
onset: depens upon route: 5min- 1 hour
peak: unknown- 4 hours
duration: 1-8 hours depending on the medication

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14
Q

NSAIDS therputic uses

A

inflammation suprresion, analgesia, fever reduction, inhibition of platelet aggregation (only inhibitor)

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15
Q

NSAID complications, contraindications,interactions

A

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
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16
Q

NSAIDS implications

A
  • 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
17
Q

client teaching

A
  • 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
18
Q

opioid agonists moa

A
  • activates Mu and Kappa receptors producing analgesia, respiratory depression, euphoria, sedation, decreased gi motility
  • linked to physical dependence
19
Q

common opoid agonists medications

A
  • morphine
  • fentanyl
  • meperidine
  • methadone
  • codeine
  • oxycodone
  • hydromorphone
20
Q

opioid agonists routes, onset, peak, duration, half life

A

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

21
Q

opioid agonists theraputic uses

A
  • relief of moderate to sever pain
  • sedation
  • education of bowel motility
  • cough suppression (Codeine)
22
Q

opioid agonists complications

A
  • respiraotry depression
  • constipation
  • orthostatic hypotension
  • urinary retention
  • sedation
  • nausea/ vomiting
  • opioid toxic traid
23
Q

opioid agonists contraindication

A
  • pregnancy cat c
  • biliary tract surgery
  • preemies during/after delivery
  • kidney failure (memperidine only)
  • head injuries
  • extremely obese
  • hepatic or renal disease
  • hypotension
24
Q

opioid agonists interactions

A
  • other cns depressants
  • anticholinergic agents
  • antihypertensive
  • alcohol
25
Q

opioid agonists nursing implications

A
  • monitor vital signs, discontinue if res <12
  • assess pain level before and after onset of med admin
  • naloxone (narcan) is antidote for opioid overdose
  • do not use with other cns depressants
  • iv doses should be administered slowly; over 4-5 mis
  • monitor/ medicate for constipation/nausea/ vomiting
  • instruct pt to get up slowly, ask for help for toileting/ambulating, side rails up, bed low locked, floor clean, emergency equipment nearby
  • two nurses needed for disposal for extra opioids
  • monitor i+os assess for urine retention
  • avoid morphone for pt. with biliary colic- use meperidine instead
  • if pt. has physical dependence; never stop opioids abrutly
26
Q

opioid agonists pt teaching

A
  • take only as directed
  • never take with alcohol or other cns depressants
  • take only when needed, when feeling higher level of pain
  • if having breakthrough pain, call the provider
  • don’t operate heavy machinery, drive, complex activities
  • change positions slowly
  • increase fiber/fluids and physical activity
27
Q

opioid antagonists moa

A
  • briefly blocks mu, kappa, sigma receptors in the cns

- reversing analgesia, hypotension, respiratory depression, and sedation caused by opioids

28
Q

common opioid antagonists medication

A
  • naloxone
  • naltrexone
  • methylnatrzone
  • alvimonpan
29
Q

opioid antagonists routes, onset, peak, duration, half life

A

routes: iv nasal, subQ, Im, Po
onset: dependent on route 1-5
peak: 5-15 mins
duration: 45 min- unknown
half life: 30-90 mins

30
Q

opioid antagonists therapeutic uses

A
  • treatment of opioid misuse
  • reversal effects of opioids
  • reversal effects of respiratory depression n
31
Q

opioid antagonists contraindication interactions

A

complications

  • tachycardia and tachypnea
  • abstinence syndrome

contraindication;

  • pregnancy cat B (naltrexone- cat c)
  • no naltrexone with hepatitis, liver failure or lactation

interaction

  • partial opioiod agonists
  • opioid analegtsic
32
Q

opioid antagonist nurisng implication

A
  • monitor vital, heart rhythm, respiratory function
  • have emergency equipment on hand
  • be prepared for abrupt opioid withdrawal symptoms
  • half life of opioid may be longer- monitor pt. for 2 hours after admin
33
Q

opioid antagonists pt. teaching

A
  • inform pt. of opoid reversal
  • urge opioid- dependent pt to seek rehabilitation
  • inform family how to use

pharm (44 decks)

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