wk 3 drug cards

Question 1

Opioid Receptors

Mu, Kappa, Delta

Answer 1

Mu
Analgesia, sedation, respiratory depression, & physical dependence

Kappa
Analgesia, psychic effects & sedation

Delta
No pharmacology-related effects

Question 2

Generic / (Trade): aspirin, ibuprofen (Ecotrin, Motrin)
Nonopioid Analgesics: Pain
Class: NSAIDs COX1 & COX2 Inhibitors

Answer 2

Side effects: Gastric upset, heartburn, nausea, gastric ulceration, Bleeding & salicylate poisoning, Kidney dysfunction, Reye’s syndrome

Interventions/Education: Monitor for bleeding, BUN & Creatinine, Recommend PPI during NSAID therapy, Take with food

Contraindications: Preg. Risk category D, PUD, bleeding disorders, Children with a virus, Surgery, Alcohol use, Kidney dysfunction, Inc. risk of bleeding with anticoagulants, glucocorticoids, & alcohol

Question 3

Generic / (Trade):
celecoxib (Celebrex)
Nonopioid Analgesics: Pain, infamation
Class: NSAIDs COX2 Inhibitor

Answer 3

Side Effects: GI upset, Renal dysfunction, Cardiovascular & cerebrovascular events

Interventions/Education: Monitor GI, MI, & CVA s/s, Test & treat H. pylori, Bleeding (PPI), BUN & Creatinine, 2 hr before or after antacids, Take with food, Low dose aspirin daily

Contraindications: Preg risk category C & D, Severe hepatic or kidney impairment, Children,GI bleeding, Allergy to sulfa, Alcohol, DM, Dec. effects of furosemide (Lasix), Inc. anticoagulant effects, Alcohol & glucocorticoids inc. risk of bleeding

Question 4

Generic / (Trade): acetaminophen (Tylenol)
Nonopioid Analgesics: Pain, Fever
Class: Acetaminophen

Answer 4

Side Effects: HTN, lIver damage, ABD pain, n/v/d, sweating, liver damage in 48-72 hrs, Administer acetylcysteine (Mucomyst, Acetadote),

Interventions/Education: No more than 3 g/day

Contraindications: Alcohol, hepatic or kidney disease, anemia

Question 5

Generic / (Trade): tramadol (Ultram)
Nonopioid Analgesics: Pain
Class: Centrally Acting Nonopioids

Answer 5

Side Effects: sedation, dizziness, headache, n/v, constipation, urinary retention, respiratory depression, & seizures

Interventions/Education: Monitor with ambulation, lowest effective dose & short term only, give with food, monitor RR & for urinary retention, substance abuse history, liver or kidney disease, St. John’s wort inc. sedative effects

Contraindications: alcohol, resp depression, seizure disorders, & children

Question 6

Generic / (Trade): morphine (Duramorph)
Opioid Analgesics: pain, sedation, reduc anxiety
Class: Opioid Agonist

Answer 6

Side Effects: Resp. depression, Sedation & drowsiness, N/V/constipation, Hypotension, Urinary retention, Potential for abuse

Interventions/Education: CNS depressants inc. effects, St. John’s wort inc. sedation, Antihypertensives inc. hypotensive effects

Contraindications: Preg risk category D, Kidney failure, Schedule II controlled substance, Head Injury, Hypotension, Hepatic or kidney disease

Question 7

Generic / (Trade): butorphanol, pentazocine (Talwin)
Opioid Analgesics: Pain
Class: Opioid Agonist-Antagonist

Answer 7

Side Effects: Resp. depression, sedation, HA, nausea

Interventions/Education: VS, assist with ambulation, taper dose with discontinuation, use only when needed, short term basis

Contraindications: Opioid dependence

Question 8

Generic / (Trade): naloxone (Narcan)
Opioid Analgesics: reversal of opioid effects
Class: Opioid Antagonists

Answer 8

Side Effects: Inc. RR, BP, & HR, Abstinence syndrome, *may inc. pain

Interventions/Education: Monitor VS, heart rhythm, Have O2 & resuscitation equipment nearby, Administer q2-3 min until reversal of undesirable effects

Contraindications: Opioid dependence