Drug classification for Pain meds
Adverse reactions to salicyclates (5)
, GI symptoms, blood dyscrasias - clotting factors ie hemophiliacs, hearing problems.
What is the maxium dosage for tylenol
4000 milligrams
Analgesics-
: little to no anti-inflammatory effect, available over the counter, and in combination with opiates. Medications that relieve pain without causing loss of consciousness
What can you do for a patient with a fever?(3)
A cool cloth, you can put him on a cool pad, there's these acqua pads that they have not it goes cold and it goes hot.
What are these examples of? Prednisone, hydrocortisone, pulmacort inhaler, flonase - nasal, solu-medrol - IV short acting, Dexamethason IV - long acting
Corticosteriods
What are serious sideffects of NSAIDS (14)
GI bleeds or upset, epigastric upset (GERD), nausea, necrosis lesions. Renal function needs to be watched, watch creatanin levels, BUN levels, renal failure, cardiovascular, edema - can be medication induced, dizziness, drowsiness, or rash.
Contraindication for salicyclates? (4)
Hypersensitivity rash, diarrhea. Peptic ulcer disease, anything GI.
What are these examples of? aspirin, torodol, motrin, advil, naproxen, oxaprozin (Daypro), celecoxib (Celebrex), indomethaxin (Indocin)
NSAIDS antipryetics and analgesics
If you have a bad reaction to an opioid itching respiration less than 12 and you cant wake up. A nurse will give you?
Narcan, if you have too much medication in you and you have a respiration of less than 12, and you can't wake up. The main thing that they are watching, there is a new policy out, if your patient is on morphine or demerol they have narcan hanging even if it is at 1cc or 2ccs an hour. So if your patient is on PCA (Patient Controlled Analgesic), they usually have narcan, at least that is what I am starting to see.
Nursing implications for salicyclates?(8)
Nursing implications: you want to monitor renal and hepatic functions. You want a baseline on hearing and eye exam. You want to make sure that your patient understands what is toxic and the symptoms: blurry vision, ringing in the ear, hearing loss.
Narcotics
Pain relievers that contain opiate derivatives from the opiate poppy or chemical related opium narcotics are very strong pain relievers
Corticosteroids:
Produce profound and varied metabolic effect, in addition to modifying the normal immune response and suppressing inflammation
What are these an example of? Aspirin 650mg, Bufferin, Ecotrin, Bayer Aspirin, St. Joseph Aspirin.
Salicyclates
What do you expect a patient with pain management to have?(2)
Some people who are in pain management will have a percocette and an NSAID as well.
How do you taper a diabetic off corticosteriods?
This medication is on a schedule the first week you take one every day, for three days you take 1/2 pill, then for 2 days take 1/4 pill. They will taper this medication off, this cannot be stopped suddenly.
What type of patient should not have a bronchiodilator?
a breast feeding patient
What do you monitor therapuetically for anti inflammatory?(2)
a decrease in swelling because you are giving it as an anti-inflammatory, or that the patient has decreased stiffness because he has arthritis, or tenderness in joints or muscles.
What is the indication for opiates
alleviate moderate to severe pain, often given as an adjunct to analgesic drugs.
Nursing implications, corticosteroids - monitor signs and symptoms for?(5)
anorexia, nausea, weakness, fatigue, hypertension, hypoglycemia.
(3) uses for aspirin?
anticoagulant antipryetic analgesic inhibits prostatglandins
Anticoagulant + anon steriod
anticoagulant with a non-steroid medication, aspirin to some extent, corticosteroids, ulcer medications can interfere, protein binding medications.
What are NSAIDS?(2)
antipryetics and analgesics
What are primary drugs for pain relief?(5)
are NSAIDs, antidepressants, anticonvulsants, corticosteroids, opioids
Examples of Narcotics(6)
are codeine, demerol, methodone, morphine, oxycodone, and fentanyl. These manage moderate to severe pain.
What are used to manage moderate to severe pain?(6)
are codeine, demerol, methodone, morphine, oxycodone, and fentanyl. These manage moderate to severe pain.
Who are bronchodilators administered for?(4)
asthma, COPD, emphysema, bronchial spasm
What are uses for aspirin
blood thinner, We give it for acute onset of gout, bone, joint and muscle pain. Some forms of arthritis, dysmenorrhea, and fever - when we take aspirin for fever the dose is usually 650mg.
Inhalation corticosteriods are used for?(3)
chronic management of airway disease, asthma, COPD.
Example of analgesics (4)
codeine, fentanyl, IV, patch, epidural.
What are their other uses?(3) are NSAIDs, antidepressants, anticonvulsants, corticosteroids, opioids a
cough center suppression, treatment for diarrhea, a balanced anesthesia.
Adverse effects of opiates:
giddy, euphoric, CNS depression, nausea and vomiting, respiratory depression, urinary retention, constipation, diaphoresis and flushing, pupil restriction, constipation and itching.
How should you monitor a diabetic patient on corticosteriods?
his is the patient that even though they are not diabetics they need to have blood sugars taken. It is usually ordered to be done once to twice a day because the steroids increase blood sugar.
What are topical corticosteriods used for?(2)
inflammation or for an allergic reaction.
What is an adverse sidefeffect exclusive to Demerol or morphine
itchiing
What are contraindication for opiates?(5)
known drug allergies, severe asthma or other respiratory insufficiency because it suppresses respirations, it suppresses CNS, it elevates intracranial pressure so you want to make sure that your patient does not have a problem, and pregnancy, especially during the first and the last trimester.
What is big chief complaint with indocin?
may take the indocin in the morning on an empty stomach and causes stomach upset, usually that is a complaint.
What are indications for NSAIDS?(4)
mild to moderate pain, it is an anti-inflammatory, antipyritic effect, relieves vascular headaches
What are contraindications for a patient with a bronchiodilator?(5)
narrow angle glaucoma, severe cardiac disease (Tachy-dysrhythmias), hypersensitivity, lactation - somebody who is breastfeeding
What does a 650 milligram dose of aspirin mean?
patient with a fever
What are nursing implications for NSAIDS nursing implications, again nursing (4)
peptic ulcer disease or GERD, cardiac function, and renal function, platelet count.
What is chronic pain
persistent or recurring pain lasting six weeks or longer
What corticosteriods are you going to push on a patient with COPD?(2)
solu-medrols and dexamethason
Pain threshold-
the level stimulus needed to produce the percetion of pain a measure of physiologic response of the nervous system.
What is 81 mg dosing for aspirin for?
to prevent heart attacks 325 milligram
What should you take for a sudden head ache onset or acute pain?(2)
tylenol advil
Pain-
unpleasent sensory and emotional experience associated with actual or potential tissue damage
Salicyclates: indiciaton
used for mild to moderate pain
Bronchodilators
used for treatment of reversible airway obstruction
When you are educating your patient you want to talk about?
various adverse reactions, and notify the doctor, if the patient tells you that every time a take a medicine it makes them nauseated you need to tell the doctor, you may need to change the medication or the dosage may need to change. Instruct the patient to watch their bowel movements and to report any findings like bright red color, or blood, and if they do see this they should contact their doctor immediately or go to the emergency room
What are the contraindications for corticosteriods?(9)
vertigo, paper thin skin, brittle frail nails, peptic or esophageal ulcer, retain fluids, moon-face with long term steroid use, skin is extremely fragile - paper thin, when you start an IV all the blood pools underneath the tissue.
Contraindication for salicyclates (3)
who has an ulcer, pregnancy, bleeding disorder, or GI disorder. Do you see a pattern? All pain medications are tough on the GI system. When you are on pain medications you want to watch renal function. See the pattern?