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Drugs for Pain & Inflammation
Pain Drugs
14
Pharmacology
Undergraduate 1
02/03/2016

Additional Pharmacology Flashcards

 


 

Cards

Term

Pain 

Definition
  •  Tissue damage activates free nerve endings (nociceptors) of peripheral nerves 
  • Nociceptors - abundant in arteriole walls, joint, muscle, skin, soft tissue 
  • Acute vs. Chronic pain (require different treatments) (chronic pain - 3 months or longer) 
  • Opioids vs. Nonopiod meds 
Term

Analgeis-Antipyretic-Anti-inflammatory drugs 

Definition
Action – inhibit the formation of prostaglandins in inflamed tissue, preventing the stimulation of pain

May have anti-inflammatory, anti-pyretic or anti-platelet effect

 

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Term

Aspirin (Acetylsalisylic Acid)

 

 

NSAID 

Definition

Prototype: Aspirin (for the NSAIDS) 

 

Action: 

  • Non-selectively inhibits COX (1 & 2) / inhibits formation of prostaglandins 
  • analgesic, anti-pyretic, anti-inflammatory & antiplatelet 

Therapeutic Use: 

  • mild to moderate pain / fever / inflammation / decreases risk of thrombus (PFIT)
  • low dose given for: MI / angina / stroke / primary prevention of MI / thromboembolism prevention in surgery patients (MASPT) 

Adverse Effects: stomach irritation / bleeding 


Nursing Education: 

  • Toxicity - salicysm, tinnitus (ringing in ears)
  • Avoid other otc meds that contain ASA
  • Stop use 2 weeks before/after invasive procedures
  • TAKE WITH FOOD, & ADEQUATE FLUIDS
  • highly bound drug to blood albumin
  • DO NOT GIVE TO CHILREN R/T REYE'S SYNDROME
  • Watch for signs of bleeding
  • Not for use in pregnancy 
  • Increased effects with ETOH, anticoagulants, opioids, steroids

 

Term

Acetaminophen (Tylenol) 

Definition

IV: Ofirmev


Action: 

  • antipyretic and analgesic effects only (doesn't cause GI effects of aspirin) 

Therapeutic Use: 

  • reduces pain & fever (can use with GI problems) 

Adverse Effects: hepatic failure with high doses / nephrotoxicity with overdose  


Contraindications: 


Nursing Education: 

  • Read labels
  • NO MORE THAN 4 GRAMS/DAY
  • Drug of choice for: febrile children, elderly & impaired renal function, pregnancy
  • alternate acetaminophen and ibuprophen for children's fever
  • watch for duration of use
  • avoid ETOH 


Misc: 

  • May use with GI problems 
  • additive effect w/ other opioids 
  • Overdose treatment: Mucomyst (orally) 

 

Term

NSAIDS 

Definition

Ibuprofen (Motrin, Advil) 



Action: 

  • antipyretic, analegesic, anti-inflammatory

Therapeutic Use: 

  • fever / pain / inflammation / arthritis / menstrual cramps 

 

Misc: 

  • less GI upset than ASA


Indomethacin (Indocin)


Action: 

  • analgesic, antipyretic, STRONG anti-inflammatory

Therapeutic Use: 

  • fever / pain / inflammation / arthritis / menstrual cramps 

 

Misc: 

  • Higher risk of side effects than Motrin 


naproxen (Naprosyn, Aleve) 
ketorolac (Toradol) 

Action: 

  • antipyretic, analegesic, anti-inflammatory
  • given via IV

Therapeutic Use: 

  • severe pain 

 

Misc: 

  • duration of use 5 days - > can produce bleeding 

Term

Selective COX-2 Inhibitor 

celecoxib (Celebrex)

Definition

Drug: celecoxib (Celebrex) 


Action: 

  • selective COX-2 Inhibitor 
  • block prostaglandin associated with pain and inflammation without GI upset / No GI bleeding

Therapeutic Use: 

  • arthritis 

Adverse effect: increased risk of adverse cardiovascular event / risk of GI bleeding with long term use 

 



Nursing Implications: 

  • Advise patient of risk 
Term

Anti-Gout Agents 

Definition

Prototype: Colchicine


Other Drugs: 

  • allopurinol (Zyloprim)

Action: 

  • prevents uric acid formation 

Therapeutic Use: 

  • treatment & prevention of gout

Nursing implications: 

  • Give w/ food
  • Increase fluid to 3000 mL/day
  • Rest and immobolize affected area
  • Avoid ETOH
  • Low purine diet (anchovies, sardines, game meats, organ meats, yeast)
  • May cause drowsiness


Misc: 


Gout is the body's inability to metabolize uric acid


symptoms: hyperuricemia (>6 mg/dL), sever pain, inflammation and edema in musculoskeletal system 

 

Term

Other: pregabalin (Lyrica)

Definition

Action: 

  • decreases number of pain signals sent out by damaged nerves

Therapeutic Use: 

  • neuropathic pain / fibromyalgia/ partial seizures

Adverse effects:  tiredness / dizziness / N/V




 

Term

Opioid Analgesics

Definition

Action: Stimulate opiate receptors and bind to the receptors in CNS

causing inhibition of ascending nerve pathways 


Receptors: mu, kappa, delta

  • Most schedule II drugs, well absorbed orally
  • Oral - significant first pass risk

Use: for severe to moderate acute pain / terminal malignancy /MI / burns / trauma / post-op pain 

 


Adverse effects:  sedation (greatest effect) / respiratory depression / postural hypotension / flushing / N/V / constipation / urinary retention / pupil constriction 

 



Contraindications: allergy / Increased intracranial pressure / respiratory problems / dependence, tolerance, or addiction 


Nursing implications: 

  • MONITOR FOR SEDATIOn
  • Alternate with non-narcotics
  • No ETOH w/ opioids (metabolized in liver, both create sedative effects) 
  • Do not drive, operate machinery, or smoke
  • constipation is a common side effect
  • IR vs. SR 
  • May be used in PCA pumps (allows for patient to administer their own meds in controlled dosages; used post-operatively) 


*Use with caution in chronic pain b/c of dependence 

Term

Morphine 

Definition
  • Prototype for opioids 
Routes: PO, IM, IV, SQ, IT, Epidural
Effects: IV (15-20 min); PO (60 min) 

PO: Roxanol, MS contin
Transdermal: duragesic
Anesthesia, Epidural, IT: fentanyl 


Term

Additional Opioids 

Definition

oxycodone (OxyContin)

  • popular drug of abuse
  • can be combined with ASA - Percodan or acetaminophen - Percocett
hydromorphone (Dilaudid) 
  • more potent than Morphine
  • risk of oversedation
  • drug of abuse 
 
codeine  - usually w/ acetaminophen
  • can cause nausea 

 
hydrocodone (Norco)
  • schedule II, abuse issues 

 
meperidine (Demerol), synthetic
  • may cause tremors / hallucinations / seizures
  • not used much anymore b/c of uneven release 
 
tramadol (Ultram) 
  • syntehtic
  • used for chronic pain
  • schedule IV due to abuse potential 
  • becoming unfavorable 
Term

Opioid Antagonist 

Definition

Drug: naloxone (Narcan) 


 

Action: compete with opioids for receptor sites in brain 


use: reverse or block anesthesia, CNS, and resp. depression from narcotics

 


adverse effects: increased heart rate / increasted BP / increased respiratory / return of pain / produces withdrawal symptoms 


nursing implications

  • administer slowly 
  • injections may need to be repeated (due to short half-life) 
Term

Opioid Agonist / Antagonist 

Definition

Drug: 

  • butorphanol (Stadol)
  • nalbuphine (Nubain)
reduced potential for abuse 

 

Action: agonist at some receptors, antagonist at others 


 

nursing implications

  • never give to someone who has received opioid analgesics (due to antagonist activity) 
  • complicated med b/c it'll reverse effects of opioid analgesics
Term

Methadone (Dolophine) 

Definition

Action:  blocks receptors in brain affected by opioids 


longer acting than morphine, abuse, wean 


use: opioid addiction / cancer pain


 

nursing implications

  • patient must continue with treatment if ever admitted to hospital 

 



misc:

  • slow withdrawal process
  • reduces drug cravings
  • doesn't create sense of euphoria
  • effects last between 24-36 hours (daily dose)
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