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PHARM > Pain, Fever, ANS prototypes > Flashcards

Pain, Fever, ANS prototypes Flashcards

1
Q

atropine therapeutic class

A

anti-arrhythmic, bronchodilator

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2
Q

atropine pharmacologic class

A

anticholinergic (antimuscarinic)

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3
Q

action of atropine

A

inhibits the effects of the parasympathetic nervous system: increase in HR, bronchodilator, decreases GI and respiratory secretions

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4
Q

side effects of atropine

A

dry mouth, urinary retention, blurred vision, tachycardia, headache, fatigue, constipation

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5
Q

uses of atropine

A

decreases GI & respiratory secretions; use treatment of asthma/COPD; use for treatment of bradycardia

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6
Q

nursing considerations of atropine

A

avoid in acute hemorrhage, tachycardia, angle closure glaucoma

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7
Q

bethanechol therapeutic class

A

treatment of urinary retention

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8
Q

bethanechol physiological class

A

cholinergic, EX. direct-acting parasympathomimetic

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9
Q

action of bethanechol

A

directly stimulates muscarinic receptors: increasing the tone of the destrusor urinate muscle (smooth muscle) of the bladder, giving a contraction adequately effective to initiate micturition (peeing) and void (empty) the bladder

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10
Q

use of bethanechol

A

post-operatively (non-obstructive) urinary retention; neurogenic bladder (spinal cord injury or shock)

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11
Q

adverse effects of bethanechol

A

increased salivation, sweating, abdominal cramping and hypotension (could lead to fainting)

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12
Q

contraindications of bethanechol

A

do not give to pts. with asthma, epilepsy, Parkinson’s, peptic ulcer disease, bradycardia.

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13
Q

phenylephrine therapeutic class

A

nasal decongestant, antihypotensive

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14
Q

phenylephrine pharmacologic class

A

adrenergic drug (sympathomimetic); selective, alpha-adrenergic agonist

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15
Q

intranasal action of phenylephrine

A

reduces nasal congestion by constricting small blood vessels in nasal mucosa

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16
Q

intranasal contraindications of phenylephrine

A

do not use for than 5 days due to rebound congestion

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17
Q

topical action of phenylephrine

A

used in eye drops to cause pupil dilation

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18
Q

topical contraindications of phenylephrine

A

do not use in those with narrow angle glaucoma

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19
Q

parenteral action of phenylephrine

A

can reverse hypotension due to spinal anesthesia or vascular shock; lack of beta selectively (few cardiac side effects)

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20
Q

parenteral contraindications of phenylephrine

A

use in caution in those with advanced coronary artery disease, hypertension or hyperthyroidism
Black Box Warning: severe reactions including death may occur with IV infusion; use with cation and only when other routes are not feasible

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21
Q

antidote of phenylephrine

A

phentolamine (alpha-blocker) — may need to treat hypertension

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22
Q

prazosin therapeutic class

A

anti-hypertensive

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23
Q

prazosin pharmacologic class

A

adrenergic-blocking drug

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24
Q

actions of prazosin

A
  • alpha-1 adrenergic antagonist that competes with NE at its receptors on smooth muscles in arterioles and veins
  • a rapid decrease in peripheral resistance that reduces blood pressure
  • little effect on CO or HR
  • used mostly in combination with beta-blocker
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25
Q

adverse effects of prazosin

A
  • can cause orthostatic hypotension, can cause unconsciousness about 30 mins after 1st dose
  • 1st dose should be low and given @ bedtime
  • dizziness, drowsiness, and lightheadedness
  • reflex tachycardia could occur due to rapid drop in BP
  • use cautiously with other anti hypertensives and diuretics
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26
Q

NSAIDs

A

Non-Steroidal Anti-Inflammatory Drugs

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27
Q

ibuprofen therapeutic class

A

anaglesic, anti-inflammatory, anti-pyretic

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28
Q

ibuprofen pharmacologic class

A

NSAID, non-selective COX inhibitor

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29
Q

action of ibuprofen

A

inhibits the conversion of arachidonic acid to cyclooxegenase (COX) which inhibits the production of prostaglandins
*prostaglandins generated by COX-1&2 can be both protective (COX-1) and cause inflammation (COX-2)

30
Q

use of ibuprofen

A

mild to moderate pain, treatment of fever, treatment of inflammation

31
Q

nursing considerations of ibuprofen

A
  • may cause/exacerbate GI bleeding (due to inhibition of COX-1) and peptic ulcers (should avoid patients with peptic ulcers)
  • monitor for bleeding (inflammation)
  • observe or elicit signs/symptoms of GI distress (nausea, vomiting, heartburn, epigastric pain)
  • monitor hepatic & renal function
  • has cross-sensitivity with aspirin in terms of allergy/anaphylaxis – patients with aspirin allergy (itching, rhinitis, bronchospasm, angioedema) should not take ibuprofen
32
Q

aspirin therapeutic class

A

anaglesic, anti-inflammatory, anti-pyretic

33
Q

aspirin pharmacologic class

A

NSAID, salicylate, non-selective COX inhibitor

34
Q

action of aspirin

A

inhibits the synthesis of prostaglandins

35
Q

use of aspirin

A

mild to moderate pain, treatment of fever, treatment of inflammation, may prevent stroke and heart attack

36
Q

nursing considerations for aspirin

A
  • GI irritation (take with food or enteric-coated – i.e. milk)
  • use in caution with other drugs that increase risk of bleeding (warafin, heparin and clopidogrel)
  • monitor hepatic renal function
  • may lead to Stevens-Johnson syndrome, can cause laryngeal edema, anaphylaxis
    -do not use in children (combined with viral illness can cause Reyes Syndrome)
37
Q

acetaminophen therapeutic class

A

anaglesic, anti-pyretic

38
Q

acetaminophen pharmacologic class

A

anaglesic

39
Q

action of acetaminophen

A

inhibits the synthesis of prostaglandins in the brain

40
Q

use of acetaminophen

A

mild to moderate pain (often used in combination with an opioid), treatment of fever

41
Q

nursing considerations for acetaminophen

A
  • ensure correct dose administered as recommended => do not exceed daily maximum dose of 3000mg/day for adults. pediatric patients total daily max is dependent on weight.
  • hepatotoxic – ensure correct dosing. do not use in patients with hepatic insufficiency or those who drink more than 3 alcoholic drinks/day
42
Q

morphine therapeutic class

A

anglesic

43
Q

morphine pharmacologic class

A

opioid agonist

44
Q

action of morphine

A

works in the brain to inhibit pain sensation

45
Q

uses of morphine

A

uses moderate to severe pain not relieved by non-opioid medications, air hunger
- decreases labored breathing
- helps with pain while on deathbed
- ease of breathing

46
Q

nursing considerations for morphine

A
  • monitor for respiratory depression, sedation, urinary retention, nausea/vomiting, constipation
  • assess BP, pulse and respiratory rate prior to administration an during administration
  • administer stool softener (if prescribed) to avoid constipation. consider requesting PRN order for stool softener if not ordered.
  • discontinue use of opioids once pain can be managed by non-opioid medications. Potential for addiction/abuse.
  • requires 2 RN verification and signature – also needed for meds to be wasted or discarded.
47
Q

naloxone therapeutic class

A

reversal agent, antidote for opioids

48
Q

naloxone pharmacologic class

A

CNS opioid receptor antagonist

49
Q

action of naloxone

A

competes with opioids at the receptor site in the brain

50
Q

use of naloxone

A

reversal of opioid intoxication or overdose

51
Q

nursing considerations of naloxone

A
  • have drug available if administering opioids (especially a PCA or continuous IV admin)
  • administration may cause sudden withdrawal symptoms (nausea, vomiting, diarrhea, fever, sweating, body aches, crying, irritability)
  • administration may reveal underlying pain, be prepared to administer pain medication
52
Q

methadone therapeutic class

A

opioid analgesic

53
Q

methadone pharmacologic class

A

long-acting opioid agonist

54
Q

action of methadone

A

works in the brain to desensitize multiple pain receptors, blocks cravings and euphoria

55
Q

use of methadone

A

used to treat opioid use disorder or to facilitate medical withdrawal, sometimes used in chronic pain management

56
Q

nursing considerations for methadone

A
  • may be used to facilitate opioid withdrawal after an ICU stay
  • same monitoring as morphine => can cause respiratory depression
  • usually given as a taper over time
  • watch for withdrawal symptoms (nausea, vomiting, diarrhea, fever, sweating, body aches, crying, irritability) – may need to advocate for slower taper.
57
Q

sumatriptan therapeutic class

A

vascular headache (migraine) suppressant

58
Q

sumatriptan pharmacologic class

A

serotonin (5-HT) agonist

59
Q

action of sumatriptan

A

causes vasoconstriction of blood vessels in the head

60
Q

use of sumatriptan

A

migraine headache treatment

61
Q

nursing considerations of sumatriptan

A
  • not preventative, can only work once a headache has started
  • do not use in patients with angina or history of myocardial infarction
  • do not give if patient is taking ergotamine-based medications (also a 5-HT agonist)
  • may cause mild sedative effects
  • some patients experience a “triptan rush” – sense of tingling, soreness, tenderness of scalp/face/neck – transient
  • goals for migraine treatment: 1) stop headache 2) prevent future headaches
62
Q

prednisone therapeutic class

A

potential anti-inflammatory

63
Q

prednisone pharmacologic class

A

corticosteroids (or steroids)

64
Q

action of prednisone

A

decreases inflammation and suppresses immune system

65
Q

use of prednisone

A

to treat allergic disorders, skin conditions, lupus, ulcerative colitis, Crohn’s disease, arthritis, psoriasis, asthma, COPD, and many other conditions.

66
Q

nursing considerations for prednisone

A
  • may cause Cushing’s syndrome
  • do not use in someone with active infection
  • causes GI distress (take with food), can lead to peptic ulcer formation) – may need to be on a GI protective drug
67
Q

lidocaine therapeutic class

A

anesthetic, anti-dysrhythmic

68
Q

lidocaine pharmacologic class

A

sodium channel blocker

69
Q

action of lidocaine

A

most used local anesthetic, blocks neuronal pain impulses by blocking sodium channels located within the neuronal membranes

70
Q

uses of lidocaine

A

IV - used a nerve block for spinal and epidural anesthesia; dysrhythmias
Patches - relieve pain related to neuralgia or dental procedures
Intradermal - rapid local pain relief

71
Q

nursing considerations for lidocaine

A

averse effects are uncommon, early signs include symptoms of CNS stimulation, such as restlessness and anxiety, then turn to CNS depressant
- monitor for hypotension and dysrhythmias
- monitor patients with history or cardiovascular disease and lidocaine with epinephrine

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