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Nursing 171 > Pharmacology Week 11: Pain and Inflammation Management Agents; Reproductive, Genitourinary and Gender Related Drugs > Flashcards

Pharmacology Week 11: Pain and Inflammation Management Agents; Reproductive, Genitourinary and Gender Related Drugs Flashcards

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1
Q

Pain and Inflammation Management Agents

A
  • Opioid Analgesics (Morphine Sulfate)
  • Non-Opioid Analgesics (Acetaminophen)
  • Corticosteroids (Prednisone)
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2
Q

Pharmacological Pain Management

A

drugs used to control pain range from mild, over-the-counter (OTC) preparations to controlled substances and potent general anesthetics

  • Pain assessment = 5th vital sign and is an essential nursing intervention to all patients
  • Variety of pain assessment scales, most common involves patient rating their pain on a scale between 0 to 10
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3
Q

Pain

A

an unpleasant sensation and emotional response to the sensation

  • effects all areas of a persons life
  • besides pain scale, the nurse needs to assess the QUALITY and DURATION of the patients pain
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4
Q

To Assess Quality of Pain

A

ask the patient to describe the pain as:

  • sharp/ dull
  • aching
  • stabbing
  • burning
  • throbbing
  • tinging
  • searing etc.
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5
Q

To Assess Duration of Pain

A
  • Acute (short term)
  • Chronic (6 months or longer)
  • Intractable (chronic and resistant to relief)
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6
Q

Non-Opioid Analgesics

A

used for pain management and have antipyretic (fever reducer) and anti-inflammatory effects

ex: acetaminophen (Tylenol)
- inhibit prostaglandin synthesis peripherally for analgesic effect and centrally for antipyretic effect

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7
Q

Acetaminophen

A
  • Non-Opioid Analgesic
  • produces analgesic and antipyretic effects and is used in many OTC preparations
  • Adverse Reactions: skin rash, liver damage
  • recommended for short term use only
  • do not take with alcohol
  • may be taken with other OTC pain relievers
  • exceeding the recommended dosage can lead to liver + kidney function problems
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8
Q

Acetaminophen Adverse Reactions

A

-skin rash
-liver damage
(recommended for short term use, do not take with alcohol)
-alcohol use with this drug increases risk of hepatotoxicity
-exceeding the recommended dosage can lead to liver + kidney function problems

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9
Q

Opioid Analgesics

A

reduce pain by binding to opiate receptor sites in the peripheral and central nervous systems blocking the pain response

  • stimulation of the opiate receptors mimic the effect of endorphins that are naturally occurring opiates in the body
  • this receptor-site binding produces the therapeutic effects of analgesia and cough suppression
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10
Q

Opioid Analgesics Receptor-Site Binding Therapeutic Effects

A
  • analgesia

- cough supression

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11
Q

Adverse Reactions of Opioid Analgesics

A
  • respiratory depression
  • constipation
  • confusion
  • sedation
  • hypotension
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12
Q

Opioid Analgesics: Morphine

A 
may be administered by a variety of routes:
-mouth (PO)
-subcutaneously (sub q or sq)
-intramuscular (IM)
-rectally
-intravenously (IV)
-intrathecal (in spinal cord) 
>may be given orally in short or long acting forms 
>injectable
>IV as intermittent injection
>continuous infusion
>patient controlled analgesia that allows the patient control over when pain medication will be administered
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13
Q

Nurses Role in Opioid Administration

A
  • assess type, location, and intensity of patients pain prior to administering opioids and 1 hour after
  • monitor vital signs, mental status and bowel function/constipation (laxatives may be needed with long-term use because of constipation)
  • monitor signs of physical and psycho-social dependence on the drug
  • prolonged use of this drug an lead to opioid addiction or abuse
  • assess level of consciousness + vital signs before and after administration
  • Naloxone may be given with overdose to reverse respiratory depression or coma
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14
Q

What May Be Given To Reverse the Effects of Overdose in Opioids?

A

Naloxone

-may be given with overdose to reverse respiratory depression

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15
Q

Anti-Inflammatory Medications

A

protect the body from invading foreign substances and reduce inflammation in the body
-Sub-classifications–> antihistamines, corticosteroids, uricosurics

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16
Q

Anti-histamine

A
  • sub-classification of anti-inflammatory medication

- block histamine effects that occur in allergic reactions

17
Q

Uricosurics

A
  • sub-classification of an anti-inflammatory medication
  • exert their anti-inflammatory actions on uric acid
  • commonly used to treat gout
18
Q

Corticosteroids

A
  • sub-classification of anti-inflammatory medication
  • multiple drug interactions
  • suppress immune response and reduce inflammation
  • used systemically and locally in the management of a wide variety of chronic diseases including inflammatory, allergic, hematologic, neoplastic (cancer) and autoimmune disorders
19
Q

Corticosteroids: Prednisone (Patient Teaching)

A
  • Take drug as ordered. Missed doses and stopping the drug can result in complications
  • report sudden weight gain, swelling, slow healing, black tarry stools, bleeding, bruising, blurred vision, emotional changes and other unusual effects
  • medication should be administered in the morning to coincide with the bodys normal secretion of cortisol
20
Q

Complications of Long-Term Therapy of Corticosteroid Prednisone

A
  • Cushings Syndrome: “moon-like” face, weight gain, thin, easily bruised skin, hypertension, depression and diabetic symptoms: thirst, polyuria, polyphagia (extreme hunger)
  • can decrease calcium and vitamin D levels, cause osteoporosis and infection
21
Q

Corticosteroid: Prednisone

A
  • be aware of early signs of adrenal insufficiency including–> fatigue, muscle weakness, joint pain, fever, anorexia, nausea, dyspnea, dizziness + fainting
  • must be withdrawn gradually from the drug
  • abrupt withdrawal or increased stress can result in death because it causes acute adrenal insufficiency
  • medication should be administered in the morning to coincide with the bodys normal secretion of cortisol
22
Q

Reproductive Hormones

A
  • Oxytocin

- Estrogen Supplements

23
Q

Estrogens

A

mimic the physiological effects of the naturally occurring female sex hormones

  • used to correct estrogen deficient states and in conjunction with hormonal contraceptives, prevent pregnancy
  • treatment of hormone-sensitive tumors
24
Q

Androgens, Anti-Androgens, Progestins, and Gonadotropin-releasing Hormone Analogues

A

treat a variety of reproductive cancers including breast, prostate, endometrial and renal

25
Q

Reproductive Hormones: Estrogen Supplements

A
  • prescribed primarily for estrogen replacement therapy in post-menopausal females
  • given to women with reduced ovarian hormonal secretion
  • for palliative treatment of advanced beast cancer
  • Women’s health initiative study reported: increased heart attack, stroke, breast cancer, pulmonary emboli and deep vein thrombosis in women taking for 5 years or more
26
Q

Patient Teaching for Estrogen Replacement Therapy

A
  • diabetic patients may experience symptoms of hyperglycemia or glycosuria (excretion of glucose in urine)
  • many adverse reactions may occur
  • keep timely schedule of gynecologic and mammogram appointments
  • can lead to development of cardiovascular and breast cancer
27
Q

Adverse Reactions of Estrogen Replacement Therapy

A

-elevated BP (hypertension)
-breast tenderness
-weight changes
-thromboembolism
(check for thromboembolic disorders; pain, swelling, tenderness in extremities, headache, chest pain, blurred vision)
-shortness of breath
-severe headaches
-vision disturbances
-vaginal bleeding/ discharge
-breast lumps
-edema of hands or feet
-jaundiced skin
-pain in chest, abdomen, legs, or buttocks

28
Q

Oxytocin

A

hormonal treatment utilized for induction of labor, facilitation of miscarriage, and postpartum control of bleeding
-administered IV and stimulates uterine smooth muscle to contract

29
Q

Assessment Prior to Administration of Oxytocin

A
  • fetal maturity
  • presentation and pelvic adequacy
  • character, frequency, and duration of uterine contractions and resting uterine tone
  • fetal heart rate
  • pulse and BP of mother
  • monitor for S+S of drowsiness, listlessness, confusion, headache, anuria
  • this drug occasionally causes water intoxication
30
Q

Genitourinary Medications

A
  • Anticholinergics (Oxybutynin)

- Urinary Tract Analgesics (Phenazopyridine)

31
Q

Anticholinergic Medications

A

block the impulses of the neurotransmitter acetylcholine

  • used to treat spastic or hyperactive conditions of the GI or urinary tract because they relax muscles and decrease GI secretions
  • used to treat other conditions–> pre-operatively to reduce secretions, increase heart rate, dilate eyes during eye exams
32
Q

Uses for Anticholinergic Medications

A
  • treat spastic or hyperactive conditions of the GI or urinary tract because they relax muscles and decrease GI secretions
  • treat pre-operatively to reduce secretions
  • increase heart rate
  • dilate eyes during eye exams
33
Q

Anticholinergic: Oxybutynin Therapeutic Effects

A
  • decreased urge incontinence
  • decreased urinary frequency + urgency
  • increased bladder capacity and delayed desire to void
34
Q

Anticholinergic: Oxybutynin Side Effects

A
  • dizziness
  • drowsiness
  • blurred vision
  • constipation
  • dry mouth
  • nausea
  • urinary retention
35
Q

Anticholinergic: Oxybutynin: What to Assess for and Avoid

A
  • Assess for anaphylactic reaction, voiding patterns and intake + output, and assess abdomen for urinary retention
  • prior to administering medication, a bladder scan or post void catheterization may be performed to assess the patients bladder capacity
  • Avoid concurrent use of alcohol and other CNS depressants
36
Q

Urinary Tract Analgesics/ Selective NSAIDs Patient Teaching

A
  • report history of allergic reactions to sulfonamides, aspirin or other NSAIDs
  • report signs of GI bleeding–> bloody vomitus, urine or stool or black tarry stool
  • monitor liver function as these drugs can effect liver function
  • take drug with food if stomach upset occurs
  • avoid other medications and alcohol
37
Q

Urinary Tract Analgesics: Phenazopyridine

A

provides anesthetic effect for patients with urinary tract symptoms from urinary tract infections or procedures by relieving urinary pain, itching, burning, urgency, + frequency
-drug causes reddish-orange discoloration of the urine that may stain clothing

38
Q

Teaching for Urinary Tract Analgesic: Phenazopyridine

A
  • drug causes reddish-orange discoloration of the urine that may stain clothing
  • discontinue medication when pain + discomfort has stopped (2-3 days) but continue taking full dose of antibiotic
  • administer with or after meals to decrease GI irritation
  • do not crush
  • can not be used prophylactically (this drug does not prevent UTIs but treats symptoms associated)

Nursing 171 (38 decks)

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