Pain Medications Flashcards
Non-Narcotic Analgesics
- used for mild to moderate pain
- inhibit prostaglandin synthesis, preventing pain sensation
Acetaminophen (Tylenol)
advantages/disadvantages
- analgesic and antipyretic effects
1) advantages: - not associated w/ abdominal upset, tinnitus, or gastric bleeding
- safe to use when taking anticoagulants
- safe for children
- not associated w/ Reye’s Syndrome
2) disadvantages: - no anti-inflammatory or antiplatelet qualtities
Acetaminophen (Tylenol)
nursing actions
- monitor renal and hepatic functions
- administer w/ full glass of water
- abdominal pain may indicate overdose (antidote: acetylcysteine (Mucomyst))
- client teaching:
- read label carefully and follow dosage recommendations
- never take more than 4 g/day
- avoid drinking alcohol while taking this medication
Non Steroidal Anti-Inflammatory Drugs (NSAIDS)
uses
side effects
- inhibits prostaglandin synthesis
1) -mild to moderate pain - antipyretic
2) -nausea - vomiting
- GI upset
- GI bleeding
- bone marrow depression
- anemia
- thrombocytopenia
3) salicylate-specific allergies - tinnitus
- confusion
- liver
- kidney
- Reyes syndrome
4) hypersensitivity (allergies) - skin rash
- angioedema
- urticaria
- dyspnea
NSAIDS
nursing actions
1) assess for contraindications
- hypersensitivity
- GI disorders
- pregnancy
- anticoagulant therapy
2) assess for signs of toxicity
- tinnitus
- decreased hearing
- nausea
- vomiting
- confusion
- lethargy
3) monitor pain and temperature
4) discontinue use 24-48 hr before surgery
5) monitor CBC including WBC, RBC, platelets, and H&H for signs of blood dyscrasias or bone marrow depression
6) avoid taking NSAIDs when taking warfarin, glucosteroids, and ACE inhibitors
NSAIDs
client education
1) drink full glass of water w/ medications
2) notify provider for signs of bleeding, bruising, or GI irritation
3) do not chew EC medications
4) avoid alcohol while on NSAIDs to reduce GI irritation
5) alternating acetaminophen and NSAIDs can reduce fever more quickly
Narcotic Analgesics and Opioid Agonists
actions
uses
1) -act on mu receptors to produce analgesia, respiratory depression, euphoria and sedation
- act on kappa receptors to produce analgesia, sedation and decreased GI motility
2) uses:
- relief of moderate to severe pain (postoperative, MI, cancer)
- sedation
- reduction of bowel motility
- cough suppressant (codeine)
Narcotic Analgesics and Opioid Agonists:
nursing measures
1) assess vital signs, especially RR
2) notify provider if RR < 12/min
3) have naloxone (Narcan) available
4) administer IV opioids slowly over 4-5 min
5) assess for bladder distention, hypoactive bowel sounds, I&O
6) auscultate lung sounds and encourage TCDB
Side Effects of Narcotics
1) respiratory depression
2) constipation
3) orthostatic hypotension
4) bradycardia
5) urinary retention
6) cough suppression
7) sedation
8) biliary colic
Narcotics: potential medical interactions
1) CNS depressants
2) barbiturates
3) benzodiazepines
4) alcohol
5) MAOI
6) anticholinergics (diphenhydramine)
7) tricyclic depressants (amitriptyline)
8) antihypertensives
Narcotics: client education
1) avoid using alcohol or drugs that affect the CNS
2) teach client how to use PCA pump
3) teach client to follow prescribed dosage
4) can be physically addictive
Narcotic Agonist-Antagonists
actions
1) Antagonistic:
-block mu receptors decreasing effects of:
-euphoria
-analgesia
-respiratory depression
-sedation
-physical dependence
-decreased GI motility
Agonistic:
-act on kappa receptors producing:
-analgesia
-sedation
-decreased GI motility
2) less potential for abuse little euphoria, and less respiratory depression
3) in high doses, anxiety, restlessness, and mental confusion can occur
*used to relieve mild to moderate pain
Narcotic Agonist-Antagonists
side effects
nursing measures/client education
1) abstinence syndrome (if give to clients addicted to opiates
2) -avoid taking w/ other opiates unless prescribed by physician
- monitor vital signs
- monitor pain levels
- hold medication if RR < 12/min
Narcotic Antagonists
side effects
nursing measures/client education
1) -tachycardia
- tachypnea
- potential for abstinence syndrome
2) -monitor VS
- keep resuscitative equipment at bedside
- do not administer orally
- observe client for withdrawal
Opioid Agonist and Antagonists
1) hydromorphone (Dilaudid)
- narcotic pain reliever, also called opioids
- treat moderate to severe pain
- extended release form for around-the-clock treatment of pain
- may be habit-forming
2) side effects:
- shallow breathing
- slow heart beat
- cold, clammy skin
- confusion
- fainting, feeling light headed
