Surgical/Pain Meds Flashcards by Madison North

IV Anesthetics Brand Names

Midazolam (Versed)
Diprivan (Propofol)

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Midazolam (Versed)
Mode Action

Quick onset
Amnesia and antianxiety
Conscious sedationwith morphine or fentanyl

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Midazolam (Versed)
Route and Rate

IVP
wait 1-2 mins before admin. more medication

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Midazolam (Versed)
Adverse Reactions

Respiratory depression

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Midazolam (Versed)
Nursing Interventions

Constant VS monitoring
Monitor airway
Resuscitation equipment available (crash, ambubag)

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Diprivan (Propofol)
Mode of Action

Induction/maintenance of general anesthesia
Sedate pts
Rapid onset with 3-5 mins duration
NO ANALGESIC ACTION

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Diprivan (Propofol)
Route

IVP / infusion
- injection into large vein to decrease pain in site

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Diprivan (Propofol)
Adverse Effects

Profound respiratory depression (apnea)
Hypotension
High risk of infection

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Diprivan (Propofol)
Nursing Interventions

Monitor VS
Resuscitation equipment available

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Local Anesthetics

Lidocaine (Xylocaine)
Lidocaine with epinephrine
Spinal/Epidural Nerve Block

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Epinephrine is a

vasoconstrictor

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Epinephrine __________ blood flow and _________ absorption

decreases; delays

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Epinephrine does what with anesthesia?

prolongs and reduces the risk of toxicity

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Lidocaine
Route

injected into the immediate area of surgery

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Lidocaine
Adverse Reactions

Allergic dermatitis to anaphalaxis

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Lidocaine
Nursing Interventions

Avoid hazard activities
Maintain IV access for emergency

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Regional block

protect area from injury due to numbness

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Epinephrine is contraindicated for

fingers/nose/body parts with end arteries
due to vasoconstriction

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Spinal/Epidural Nerve Block
Adverse Reactions

Hypotension, bradycardia, cardiac arrest due to sympathetic block

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Spinal/Epidural Nerve Block
Nursing Interventions

Monitor pt during insertion for decreased B/P, seizures, respiratory depression
Spinal HA
Post edu: remain flat in bed 12 hrs post, slowly get up and allow feeling back to the legs

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Inhalation Anesthetic TYPES

no prototype and all general

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Inhalation Anesthetic
Mode of Actions

produce unconscious and lack of responsiveness to all painful stimuli

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Inhalation Anesthetic
Adverse Reactions

respiratory depression
cardiac depression
Malignant hyperthermia
Nausea
Aspiration of gastric contents

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Muscle Spasm/Malignant hypernatremia drug

Dantrolene (Dantrium, Ryanodex, Revonto)

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Dantrolene causes

stops the release of Ca into the muscle **family hx with temperature going crazy while under sedation**

S/S of malignant hypernatremia

rapid breathing tachycardia muscle rigidity (esp. jaw) temp over 104 to 109 F Arrthymias N/V

Tx for malignant hyperthermia

Oxygen body cooling extra fluids supportive care

Dilaudid generic names

Fentanyl Morphine Hydromorphone Oxycodone

Narcotic and Narcotic/Combo body systems impacted

CNS

Dilaudid Route and Rate

IM, IV, ID PO, SL **mcg for Fentanyl**

Dilaudid Adverse Reactions

**Respiratory depression confusion** Sedation hypotension constipation nausea

Dilaudid Nursing Interventions

access VS - after giving - at peak (check with routes) Determine last BM Elderly more sensitive Tolerance developed with long term

Combo Narcotics

Oxycodone - Acetaminophen Hydrocodone - acetaminophen Codeine - Acetaminophen

Brand Name of Combo Narcotics

Percocet Lortab Norco Tylenol with codeine 3

Combo Narcotics Route

All Narcotics have ______ adverse reactions and nursing interventions.

same

Opioid Antagonists' generic name

Naloxone (Narcan)

Opioid Antagonists MOA If given before

will block the effect of opioid

Opioid Antagonists MOA If given after

will reverse the analgesia, sedation, and respiratory depression

What is an opioid "antidote" for respiratory depression?

Naloxone

Opioid Antagonist Route

IV, IM, SQ **Not PO**

The half-life of Naloxone is _________ than the opioid and must be given again during a crisis.

shorter

What is the maximum amount of Tylenol someone can take in 24 hours? If exceeded, what could happen?

4000 mg - Renal failure, cirrhosis of the liver

NSAIDs

Non-steroidal anti-inflammatory drug

Aspirin Route and capsule type

PO, enteric-coated or timed release

Aspirin Contraindicated by

peptic ulcer, bleeding disorder, renal impairment

Aspirin Results

reduces pain, fever, anti-inflammatory Give with food/water to decrease GI issues

Low doses of aspirin are used for patients to protect from

MI Ischemic stroke

What medication is described? Adverse reactions are rare when taken at therapeutic doses

Ibuprofen (Advil, Motrin) Naproxen

T/F: Ibuprofen can cause GI/Renal issues but usually less.

True

What NSAID drug has no protection against MI/Ischemic stroke?

Ibuprofen

What is the IV form of acetaminophen?

Ofirmev

Ofirmev infusion rate?

15 mins

Ofirmev can mix with other meds?

What NSAID has no GI or renal issues?

Tylenol adverse reactions rare

What happens when a patient overdoses on Tylenol?

severe liver injury

High-risk patient for Tylenol

drink more than 3 alcoholic drinks daily Warfarin Severe hepatic impairment Severe active liver disease

Peak analgesic effect of Tylenol

1 hour

Tylenol duration

4-6 hours

Nonopioid Centrally Acting Analgesics

Tramadol

Tramadol should not be given to patient with

seizure hx suicidal ideation addiction prone excessive alcohol use

Tramadol Med-Oral starts max duration

1 hour 2 hour 6 hours

COPD Medication

Albuterol Terbutaline Pulmicort Fluticasone inhalation Azmacort Prednisone Advair Acetylcysteine

Bronchodilators

Albuterol Advair Terbutaline

Inhaled Corticosteroids

Pulmicort Fluticasone inhalation Azmacort

Glucocorticoid

Prednisone

Mucolytics

Acetylcysteine

Asthma medications

Cromolyn sodium montelukast theophylline atrovent HFA

Cromolyn sodium

mast cell stabilizer

montelukast

leukotriene modifiers

theophylline

methylxanthines

atrovent HFA**

anticholinergic bronchodilators

TB Meds

Isoniazid/INH Rifampin Ethambutol Pyrazinamide BCG vax

Pneumonia Meds

**Quinolones Ciprofloxacin (Cipro) Levoflaxacin (Levaquin) Penicillin Cephalosporins** Carbapenems Macrolides VAX Decongestants Topical - ephedrine Antitussives Mucinex

Penicillin

Amoxicillin Piperacillin

Cephalosporins

Ceftriaxone Cefazolin Cephalexin Cefotetan

Carbapenems

Meropenem

Macrolides

Erthromycin Azithromycin

Decongestants

Phenylephrine Pseudoephedrine

Antitussives

Promethazine (antihistamine), phenylephrine (vasopressor), and codeine Dextromethorphan (glucocorticoid)

The conscious sedation combo is

Versed and opioid through IVP