pain meds and anesthesia (exam 3) Flashcards
a sensory and emotional experience associated with actual or potential tissue damage
pain
what kind of pain is r/t tissue injury
nociceptive
where is somatic nociceptive pain
bone/muscle/joint
where is visceral nociceptive pain
heart/liver
what is pain produced by the nerves?
neuropathic pain
what is an example of peripheral neuropathic pain?
diabetes
what is an example of central neuropathic pain?
stroke
what is the pain pathway?
site of injury -> spinal cord -> brainstem -> cerebrum
is pain subjective or objective?
subjective
when is the FLACC pain scale used?
in children 7 or younger
what drugs relieve moderate to severe pain by blocking pain signals from reaching the brain and inhibiting prostaglandins
opioid analgesics
what are drugs from different classes that change pain and help reduce opioid use?
multimodal therapy
what is our example opioid agonist?
MORPHINE SULFATE
codeine, fentanyl, hydromorphone
what med binds to pain receptors in the brain to block pain impulse?
opioid agonist (morphine sulfate)
what is the use of opioid agonist (morphine sulfate)
prevent or relieve moderate to severe pain
what is the onset of IV opioid agonist (morphine sulfate)
10-20 min
what is the onset of PO opioid agonist (morphine sulfate)
60 min
what are adverse effects of opioid agonist (morphine sulfate)?
resp depression, cns depression, constipation
what is the BBW for opioid agonist (morphine sulfate)?
resp failure if used in combo with benzos or other CNS depressants
-risk for abuse and dependence
contraindication for opioid agonist (morphine sulfate)
respiratory compromise, liver/kidney disease, increased ICP/head injury
what is the reversal agent for opioid agonist (morphine sulfate)
naloxone
what is the push rate for opioid agonist (morphine sulfate)
5 ml/5 mins
what happens when opioid agonist (morphine sulfate) administration leads to a respiratory rate below 8?
naloxone administration is needed
what kind of diet while taking opioid agonist (morphine sulfate)
high fiber, lots of water
what is our example opioid agonist/antagonist
butorphanol
which med activates some receptors and also blocks some, leading to pain blocking with less potential for abuse
opioid agonist/antagonist (butorphanol)
what is used second line for moderate-severe pain, labor pain, and perioperatively
opioid agonist/antagonist (butorphanol)
adverse effects of opioid agonist/antagonist (butorphanol)
CNS depression, resp depression, risk of abuse and dependence
contraindications for use of opioid agonist/antagonist (butorphanol)
use of opioid agonist (blocks relief)
T or F?
-you can combine opioid agonist/antagonist (butorphanol) with opioid agonists (morphine)
false
what is our example opioid antagonist?
naloxone
what med reverses analgesia and displaces opioids at the receptor site?
opioid antagonist (naloxone)
what are adverse effects of opioid antagonist (naloxone)
immediate withdraw symptoms
opioid antagonist (naloxone) only reverses… ?
opioid agonists
why may people need multiple doses of opioid antagonist (naloxone)
short half life
what is the IV onset of opioid antagonist (naloxone)
2 minutes
what is the intranasal onset of opioid antagonist (naloxone)
8 minutes
what is important to regularly assess with a patient on morphine?
respirations
a man is difficult to arouse after IV morphine sulfate. his resps = 7. which is priority?
-place nasal cannula
-administer naloxone
-increase IV fluid rate
-place in semi-fowlers
administer naloxone
