Surgical/Pain Meds Flashcards
IV Anesthetics Brand Names
Midazolam (Versed)
Diprivan (Propofol)
Midazolam (Versed)
Mode Action
Quick onset
Amnesia and antianxiety
Conscious sedationwith morphine or fentanyl
Midazolam (Versed)
Route and Rate
IVP
wait 1-2 mins before admin. more medication
Midazolam (Versed)
Adverse Reactions
Respiratory depression
Midazolam (Versed)
Nursing Interventions
Constant VS monitoring
Monitor airway
Resuscitation equipment available (crash, ambubag)
Diprivan (Propofol)
Mode of Action
Induction/maintenance of general anesthesia
Sedate pts
Rapid onset with 3-5 mins duration
NO ANALGESIC ACTION
Diprivan (Propofol)
Route
IVP / infusion
- injection into large vein to decrease pain in site
Diprivan (Propofol)
Adverse Effects
Profound respiratory depression (apnea)
Hypotension
High risk of infection
Diprivan (Propofol)
Nursing Interventions
Monitor VS
Resuscitation equipment available
Local Anesthetics
Lidocaine (Xylocaine)
Lidocaine with epinephrine
Spinal/Epidural Nerve Block
Epinephrine is a
vasoconstrictor
Epinephrine __________ blood flow and _________ absorption
decreases; delays
Epinephrine does what with anesthesia?
prolongs and reduces the risk of toxicity
Lidocaine
Route
injected into the immediate area of surgery
Lidocaine
Adverse Reactions
Allergic dermatitis to anaphalaxis
Lidocaine
Nursing Interventions
Avoid hazard activities
Maintain IV access for emergency
Regional block
protect area from injury due to numbness
Epinephrine is contraindicated for
fingers/nose/body parts with end arteries
due to vasoconstriction
Spinal/Epidural Nerve Block
Adverse Reactions
Hypotension, bradycardia, cardiac arrest due to sympathetic block
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
Inhalation Anesthetic TYPES
no prototype and all general
Inhalation Anesthetic
Mode of Actions
produce unconscious and lack of responsiveness to all painful stimuli
Inhalation Anesthetic
Adverse Reactions
respiratory depression
cardiac depression
Malignant hyperthermia
Nausea
Aspiration of gastric contents
Muscle Spasm/Malignant hypernatremia drug
Dantrolene (Dantrium, Ryanodex, Revonto)
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
PO
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?
NO
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