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NURS 2750 Health and Healing > Week 2 Pharmacology > Flashcards

Week 2 Pharmacology Flashcards

1
Q

pain

A

-subjective in nature
- acute or chronic
-somatic or visceral vs neuropathic

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2
Q

analgesics

A

meds that relieve pain

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3
Q

what are 2 main types of analgesics

A

opioids and non opiods

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4
Q

what are non opioid analgesics

A

nsaids
acetaminophen
antidepressants
anticovulsants

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5
Q

nsaids

A

block cox1 & 2 enzymes
for fever and pain

ex.
ibuprofen
naproxen
celecoxib
ketorolac

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6
Q

what happens when cox 1 enzymes blocked

A

less chemicals that promote
- gastric mucosal healing
- vasoconstriction
- platelet dumping

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7
Q

what happens when cox 2 enzymes blocked

A

less chemicals that cause
-vasodilation
-inflammation
- pain
- reduce platelet clumping

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8
Q

whats the definition of shunting

A

blocks one chemical and gets more production of another chemical

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9
Q

how much do nsaids decrease pain by

A

1-3pts

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10
Q

what are common adverse effects of nsaids

A

diarrhea
GI upset

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11
Q

what are serious adverse effects of Nsaids

A

renal failure/dysfunction
GI bleeding

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12
Q

what are nsaids contraindicated for?

A

hemorrhage
heart failure
recent MI
liver failure
GI ulceration/bleeding

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13
Q

what do cox 2 selective inhibitors have a higher risk of

A

cardiovascular issues

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14
Q

what drugs are commonly required when taking nsaids

A

stomach/ gastric protection drugs

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15
Q

acetaminophen (tylenol)

A

works for fever and pain
no side effect of bleeding

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16
Q

how much is acetaminophen likely to decrease pain by

A

0.5-2 pts

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17
Q

whats the antidote of tylenol

A

acetylcysteine

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18
Q

whats the MOA of antidepressants thought to be

A

NT modulation in brain

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19
Q

what type of pain are antidepressants used for

A

neuropathic

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20
Q

how long does it take to see effects of antidepressants

A

a month or longer

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21
Q

what are the 2 main classes of antidepressants used for pain management

A

TCAs
SNRIs

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22
Q

how can antidepressants help with pain management

A

alter NE and change the perception of pain

23
Q

what side effects do opioids cause

A

urinary retention
blurred vision
dry mouth/throat
constipation
tachycardia
feeling hot/decreased sweating
sedation
confusion
dizziness
hallucinations

24
Q

how do anticonvulsants work for pain

A

generally unknown act as a CNS depressant

25
Q

when should anticonvulsants be administered

A

low doses at bedtime

26
Q

what are adverse reactions to anticonvulsants

A

dizziness
somnolence
cerebellar toxicity
peripheral edema

27
Q

what type of pain are anticonvulsants used for

A

neuropathic

28
Q

cerebellar toxicity signs are…

A

ataxia
dysarthria
drunk walk

29
Q

what are some examples of anticonvulsants

A

gabapentin (neurontin)
pregabalin

30
Q

an opioid

A

any drug natural or synthetic that has actions similar to morphine

ex.
fentanyl
methadone
meperidine
hydromorphone
oxycodone

31
Q

Opiates

A

specific to drugs isolated from opium poppies

ex.
morphine
codiene
heroin

32
Q

what are opioids used for

A

moderate to severe
- pain
- sedation
- depression
- respiratory drive (palliative care)

33
Q

whats the MOA of opioids

A

they bind to mu and kappa opioid receptors in CNS to reduce pain

34
Q

what are narcotics

A

originally any drug that caused stupor or insensibility
any medically used controlled substances
legally: illicit or illegal substances

35
Q

what are adverse rxns of opioids

A
  • respiratory depression
  • constipation
  • miosis (pinpoint pupils)
  • orthostatic hypotesnion
  • urinary retention
    -emesis
    -euphoria
    -sedation
36
Q

what should be evaluated prior to opioid admin and after

A

assessment of
-pain
-HR
-RR
-BP

37
Q

whos most likely to have an opioid overdose

A

opioid naive

38
Q

when are lower doses of opioids required

A

elderly
hepatic impairment

39
Q

whats the best way to avoid opioid withdrawl

A

taper dose slowly

40
Q

whats a tolerance

A
  • common physiological result of chronic treatment
  • once occurs, larger dose needed to require same level of analgesia
41
Q

whats is dependance

A

physiological adaptation of the body in the presence of an opioid

42
Q

what does addiction refer to

A

pattern of compulsive drug use despite harmful consequences

43
Q

what is potency referred to

A

term applied to drugs that all have the same MOA but need different does to reach same effects

44
Q

whats a breakthrough dose

A

PRN dose - as needed

45
Q

what determines when a med will take effect as well as when to reassess for efficacy

A

route

46
Q

whas the bioavailibility of oral opioids usually

A

50%

47
Q

signs of opioid overdose

A
  • shallow/no breathing
  • vomiting/gurgling
  • skin is cold/pallor
  • unresponsive/unconscious
48
Q

how does naloxone work

A

competitive antagonism

49
Q

whats suboxone

A
  • sublingually/buccally administered alternative to methadone
  • shown to improve patient lives, reduce risk of death, transmission of HIV/viral hepatitis, incarceration, crime
50
Q

what are some nursing analgesic implications

A
  • perform thorough history before beginning therapy
  • obtain baseline vital signs
  • assess for potential contraindications
  • perform pain assessment
  • withhold and contact physician if abnormal vital signs
  • assess for constipation –> use laxatives liberally
  • opioids considered high alert med. –> double checks used to reduce risk of harm/abuse
  • DO NOT crush long acting/controlled release dosage forms
51
Q

what is a MOA of triptans

A

binding serotonin 1B or 1D receptors

cause-vasoconstriction in intracranial blood vessels

52
Q

what are adverse effects of triptans

A

dizziness
worsening nausea
transient heavy arms or chest pressure

53
Q

what are some contraindications of triptans

A

coronary artery disease
cerebrovascular disease
periph vascular disease
hypertension

NURS 2750 Health and Healing (11 decks)

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