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Pharm II (Exam1) (48, 49, 50) > Pharm II (Exam 1) (48, 49, 50) > Flashcards

Pharm II (Exam 1) (48, 49, 50) Flashcards

1
Q

What is the name of the system in the CNS that relieves pain by suppressing the transmission of pain signals from the peripheral nerves?

A

The endogenous analgesia system.

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2
Q

What is the action of pure opioid agonists?

A

Relieves pain by binding to receptors in the brain, spinal cord, and peripheral tissues.
Blocks and reduces pain transmission.

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3
Q

What do pure opioid agonists treat?

A 
Prevent or relieve acute or chronic pain 
Acute mycardial infarction 
Biliary colic 
Renal colic 
Burns 
Traumatic injuries 
Postoperative states 
Cancer
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4
Q

What are some side effects of pure opioid agonists?

A

N/V
Constipation
Decreased respiratory function
Pupil constriction

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5
Q

Contraindications of pure opioid agonists?

A 
Pregnancy
Respiratory depression
Liver/Kidney disease
Prostatic hypertrophy 
Increased cranial pressure 
Head injury 
Seizure disorders
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6
Q

Nursing interventions for pure opioid agonists?

A

Pain management
Preventing Drug-drug interactions
Assessing for Adverse effects
Respiratory status

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7
Q

Patient education for pure opioid agonists?

A 
No alcohol
No smoking
No driving
Only take as perscribed 
Sit or lie down at least 30 - 60 minutes after receiving an opioid by injection
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8
Q

Examples of pure opioid agonists?

A 
Morphine Sulfate (MS Contin, Roxanol)
Codeine
Fentanyl
Tramadol (ultram) 
Hydromorphone (Dilaudid) 
Meperdine (Demerol) 
Methodone (Dolophine) 
Oxycodone (Oxycontin, Roxicodone)
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9
Q

What is the action of Opioid Antagonists?

A

Reverses the analgesia and the CNS and respiratory depression caused by agonists. (antidote)
Prevents agonists from binding to sites, competes with opioids.

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10
Q

What are opioid antagonists used for?

A

Used for the treatment of respiratory depression caused by an overdose of opioids.

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11
Q

What are the side effects of opioid antagonists?

A 
HTN 
Tremors
Sweating 
Decreased respiratory function 
N/V
Drowsiness
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12
Q

Contraindications of opioid antagonists?

A

Narcotic abusers
Pregnancy
Respiratory depression

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13
Q

Nursing interventions for opioid antagonists?

A

Monitor pulse and respiration’s

Assess the patient for a therapeutic response

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14
Q

What are some examples of opioid antagonists?

A

Naloxone (Narcan)

Naltrexone (Depade, Revia)

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15
Q

Patient education for opioid antagonists?

A

May cause drowsiness

Inform patient that after taking this medication for a period of time, that it may cause withdraw.

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16
Q

What is the action of opioid agonists/antagonists?

A

Sedative effect
1/3 the potency of morphine
Weakly antagonizes the analgesic effect of morphone and meperidine.
Causes respiratory, cardiac, and behavioral depression.

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17
Q

What are opioid agonists/antagonists used for?

A

Pain management

Used during all phases of surgery

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18
Q

What are some side effects of opioid agonists/antagonists?

A

Risk of dependency

Respiratory depression

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19
Q

Contraindications of opioid agonists/antagonists?

A

Pregnancy/breastfeeding

Patients with or having problems associated with hypothyroidism, bowel issues, and hypertrophied prostate

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20
Q

Nursing interventions for opioid agnoists/antagonists?

A

No alcohol
Frequent vital checks (B/P & RR)
Assess pain levels

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21
Q

Patient education for opioid agonists/antagonists?

A

Do not stop taking the medication abruptly
No driving
May cause drowsiness/dizziness
Notify health care provider if pain is getting worse

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22
Q

Examples of opioid agonists/antagonists?

A

Butorphanol (stadol)

Nalbuphine (nubain)

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23
Q

What is the action of amides?

A

Diminishes pain by blocking nerve conduction
Decreases neuronal membrane permeability to Na+
Depolarization inhibitor
Inhibits the depolarization and blocks nerve conduction

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24
Q

What are amides used for ?

A

Relieving pain
Used as a local anesthesia
Numbs the area

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25
What are some side effects of amides?
``` Analgesia Numbness Metallic taste Tinnitus Agitation ```
26
Contraindications of amides?
``` Hypersensitivity Trauma Sepsis Blood dyscrasias Cardiac abnormalities ```
27
Nursing interventions for amides?
Monitor for signs and symptoms of any adverse side effects Apply to affected area topically Use nebulizer following dilution in NS/sterile H2O
28
Patient education for amides?
Report any adverse side effects Remove pain patch before applying a new one Do not eat or drink after oral intake of lidocaine for at least 60 minutes.
29
Examples of amides?
"canie" drugs | Lidocaine (anestacon, dilocaine, L-caine, lidoderm, Lidoject-1, LidoPen, Xylocaine)
30
What is the action of esters?
Decreases the influx of sodium into the nerve cell and depresses depolarization to prevent conduction of the nerve impulse.
31
What are esters used for?
Early onset anesthetic (2-5 mins; lasts about an hour) | Pain reliever
32
What does LAST stand for?
Local anesthetic systemic toxicity
33
When does LAST occur?
Occurs when the local anesthetic is absorbed systemically, resulting in extreme CNS excitation followed by cardiovascular excitation and cardiovascular collapse.
34
What are some side effects of esters?
``` LAST Analgesia Circumoral numbness Metallic taste Tinnitus Agitation ```
35
Contraindications of esters?
``` Hypersensitivity Inflammation Sepsis Meningitis Abdominal pressure Impaired cardiac function ```
36
Nursing interventions for esters?
Assess the patient for a therapeutic response | Assess the skin for any redness, itching, hives or rash
37
Patient education for esters?
Do not eat or drink anything until the numbness disappears Report any signs of a rash, hives, redness or feelings of anxiety to health care provider Do not walk/ambulate without assistance
38
Examples of esters?
Procaine hydrochloride (Novacaine)
39
What is the action of neuromuscular blocking agents?
Suspends nerve impulses at the neuromuscular junction | Can be titrated to produce weakness through complete paralysis
40
What are neuromuscular blocking agents used for?
Used to help relax skeletal muscles | Used along-side other inhalation IV agents
41
What are some side effetcs of neuromuscular blocking agents?
Anaphylaxis | Mild dermatological issues (urticaria & erythema)
42
Contraindications of neuromuscular blocking agents?
Hypersensitivity | Allergy to vecuronium or non-depolarizing neuromuscular blocking agents
43
Nursing interventions for neuromuscular blocking agents?
Maintenance of patients airway and respiratory function | ABC's!
44
Patient education for neuromuscular blocking agents?
No smoking No alcohol No supplements 2 weeks prior to surgery
45
What are some examples of neuromuscular blocking agents?
"ium" drugs Vecuronium (Norcuron) Attacurium (Tracrium) Cisatacurim (Nimbex)
46
What is the action of inhalation anesthetics?
Blocks the perception of pain | The exact mechanism of action has not yet been established
47
What are inhalation anesthetics used for ?
General anesthesia | Can be used in combination with other agents to produce a balanced anesthesia
48
What are some side effects of inhalation anesthetics?
Respiratory depression Circulatory depression Airway irritation Bronchospasm
49
Contraindications for inhalation anesthetics?
FH of malignant hyperthermia | A disease process associated with a serious disease
50
What is TIVA?
Total intravenous anesthesia
51
TIVA replaces:
The inhalation agent with a less emetic and nonmalignant hyperthermia triggering IV anesthetic for the induction and maintenance of anesthesia.
52
Nursing interventions for inhalation anesthetics?
Check B/P post-op Check/monitor vitals frequently Monitor O2 stat Provide comfort for the patient (warm blanket)
53
Patient education for inhalation anesthetics?
No smoking No alcohol No supplements 2 weeks prior to surgery
54
Examples of inhalation anesthetics?
``` "flurane" drugs Isoflurane (Forane) Desflurane (Suprane) Enflurance (Ethrane) Sevoflurane (Ultane) ```
55
What is the action of IV anesthetics?
Produces amnesia, euphoria, and hypnosis | Blocks pain perception
56
What are IV anesthetics used for?
General anesthesia Used for asthma patients (bronchodilator) Is also used for patients with COPD and pulmonary disease
57
What are some side effects of IV anesthetics?
Pain, burning, stinging sensation at the site (emulsion formula) Hiccups Myoclonic movements
58
Contraindications for IV anesthetics?
Lipid metabolism Pancreatitis Allergy to sulfates Allergic to soybean, soy products, eggs, or egg products
59
Nursing interventions for IV anesthetics?
Prevent drug-drug interactions Assess for adverse side effects Monitor VS and O2 stat
60
Patient education for IV anesthetics?
Explain the recovery phase May have burning, stinging, or pain sensation at site No smoking
61
Examples of IV anesthetics?
``` Propofol (Diprivan) Ketamine (Ketalar) Fospropofol (Lusedra) Etomidate (Amidate) Methohexital (Brevital) ```
62
What is the benzodiazepine antagonist?
Flumazenil (Romazicon)
63
What is the action of benzodiazepines?
Enhance the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties.
64
Why has the FDA issued a black box warning for Midazolam (Versed)
Because of the profound respiratory depression that may result in hypoxia, brain damage, or death.
65
What are benzodiazepines used for?
Short term sedation Temporary CNS depression Regional anesthetic
66
What are some side effects associated with benzodiazepines?
Respiratory depression Apnea At increased doses --> hypnosis
67
Contraindications for benzodiazepines?
Pregnancy --> increases the risk of cogential defects and CNS depression in the baby Pulmonary disease
68
Nursing interventions for benzodiazepines?
Monitor vitals Assess LOC frequently during sedation Assess LOC 2-6 hours post-sedation
69
Patient education for benzodiazepines?
No alcohol Know your limits Educate patient regarding dependency of benzos
70
Example of a benzodiazepine?
Midazolam (Versed)
71
Adjuvant medications used in general anesthesia?
Midazolam (Versed) | Fentanyl (Sublimaze)
72
What is acute pain?
Results from injury trauma, spasm, disease processes, and treatment or diagnostic procedures that damage body tissues. (Sharp or cutting)
73
What is somatic pain?
Results from stimulation of nociceptiors in the skin, bone, muscle, and soft tissue. (Sharp, burning, gnawing, throbbing, or cramping)
74
What is an example of chronic somatic pain?
The bone and joint pain of arthritis
75
What is an example of acute somatic pain?
A sprain or other traumatic injury
76
What is visceral pain?
Results when nociceptors are stimulated in abdominal or thoracic organs and their surrounding tissues. (Deep, dull, aching, or cramping)
77
What are some examples of visceral associated pain?
Cholecystitis, panceratitis, uterine disorders, and liver disease.
78
What is neuropathic pain?
Caused by lesions or physiologic changes that injure peripheral pain receptors, nerves, or the CNS; it is the excessive excitability in the damaged area or surrounding normal tissues, so that nerve cells discharge more easily. (Severe, shooting, burning, or stabbing)
79
What are some examples of neuropathic associated pain?
Diabetes mellitus (diabetic neuropathy) Herpes zoster infections (postherpetic neuralgia) Traumatic nerve injuries Cancer or some cancer treatments
80
Monoamine oxidase inhibitors (MAO) should not be taken with Morphine Sulfate, why?
Increases the risk of HTN, respiratory depression, or coma; should not be taken within 14 days or each other
81
What are the 4 elements associated with general anesthesia?
Amnesia Analgesia Hyposis Muscle relaxation
82
What are the 3 phases of general anesthesia?
Induction--> rendering the patient unconscious Maintenance --> administering a continuous level of anesthetic Emergence --> stopping anesthetic to allow patient to wake up
83
Local anesthetic agents may be _______, _______, or ________.
Topical, spinal, or epidural
84
Lidocaine is classified as a ______ _______ ________?
Local amide anesthetic
85
Procain is classified as a _______ _______ ________?
Ester local anesthetic

Pharm II (Exam1) (48, 49, 50) (1 decks)

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