bacterial toxin that has been changed to a nontoxic form.
example: tetanus & diptheria
a live virus that has been weakened or avirulent. It CAN cause disease in immunocompromised individuals
vaccine made with dead microbe or isolated microbial components
occurs in response to infection or administration of a vaccine or toxoid. it may take several weeks to provide protection, but usually is long lasting.
provides immediate preformed antibodies (immunoglobins) to protect against a specific antigen. It does not last very long
contains high concentrations of antibodies againse a specific antigen.
Measules, Mumps, & Rubella
Comes in 3 doses
serious side effects: thrombocytopenia & anaphylaxis
Use caution: in patients with gelatin or eggs, severe immunodeficiency
protects against: Diptheria, tetanus, & pertussis
Booster every 10 years
5 injections starting @ 2 months
IPV inactivated version
Use caution in patients with: streptomycin, neomycin, and bacitracin allergies
4 doses starting at 2 months
pain rating 1-3
treated with nonopioids
pain rating 4-6
treated with weak opioids
pain rating 7-10
treated with strong opioids
Have a ceiling effect
Do not produce tolerance or physical dependence
Many available w/o a prescription
There is no dosing limit/ceiling effect
Antitussive (cough) & antidiarrheal properties
respiratory depression, sedation, CONSTIPATION, itching, postural hypotension, urinary retention.
Bind to receptor and cause analgesia
Block transmission of pain to brain
Example: Morphine Sulfate
Bind to receptors and blocks action. Does not cause analgesia.
Example: Narcan, used to treat opioid overdose.
Bind to receptors as agonists and produce weak antagonist effects.
Less chance for resp depression, low potential for abuse, less analgesia.
Example: Pentazocine, Butotphanol.
*these should never be used in patients who have developed a physical dependency on opioids because it will cause withdrawal.
Tyenol #3: Codiene & tylenol
Lortab/Vicodin: hydrocodone & tylenol
Percocet, Tylox: oxycodone & tylenol
Oxycontin: extended release
Should only be used for short period of time (max 2 days)
Can cause: seizures & tremors b/c of toxic metabolite
drugs that are not classified as pain medication, but assist in decreasing pain.
Examples: antidepressants, antisezure meds, caffeine, corticosteroids, anxiolytics
Preferred route for chronic pain control:
Expected onset 30 minutes
Patient controls delivery of medication
Dosage is preset, they can exceed it.
Use less drug, fewer side effects, & helps nurse out.
Monitor vital signs/side effects closely.
patient will go through physical withdrawal if drug is stopped.
*this does not mean someone is psychologically addicted to a drug, it is a normal response of the body.
compulsion to do whatever it takes to get the medication.
exhibiting "addictive behaviors" because their pain is being undertreated.
Suppress pain by blocking sodium channels in a localized area
Can be used with generalized depression of nervous system
*use with vasoconstrictors (epinephrine), prolongs anesthesia & prevents toxicity. Do not use epi in areas supplied by end arteries
Example: Lidocaine, lasts 15-45 minutes
drugs that produce unconsciousness and a lack of responsiveness to all painful stimuli.
two main groups: inhalation & IV
Taken in by lungs & expired out of body
Adverse effects: resp and cardiac depression, malignant hyperthermia, aspiration of gastric contents, hepatoxicity, sensitivity of heart to catecholamines
Neuromuscular Blocking Agents
prevent contraction of skeletal muscles (including diaphragm)
Reduce the amount of anesthesia needed
Given for induction of anesthesia
induction and maintenance of anesthesia
profound resp depression
hypotension, bacterial infection
Michael Jackson drug
analgesic, antipyretic, anti-inflammatory, antiplatelet,decreases risk of stroke/MI
Side effects: GI bleeding, tinnitus
NSG considerations: Give with food to prevent GI upset
antipyretic & analgesic
Side effects: hepatoxic, should be used cautiously in patients with liver impairment.
Overdose: treated with Mucomyst (horrible smell & taste) give w/ cola or juice
NSAID that was made to cause less GI distress
Increased risk for stroke & MI
Not recommended for long-term use
Total daily intake of acetaminophen should not exceed....
Codeine & Tylenol
Hydrocodone & Tylenol
Propoxyphene & Aspirin
*serious toxicity to the heart, taken off the market
Oxycodone & Tylenol
Clinical application of glucocorticoids
Suppress immune response & inflammation
Uses for glucocorticoids
RA, Lupus, tendonitis, nausea/emesis, organ transplant, asthma, cancer, preterm infants, drug allergy
How do glucocorticoids work?
Bind inside of the cell's cytoplasm and modulate the production of regulatory proteins
Adverse effects of glucocorticoids:
Edema (Na+ & water retention)
Increased appetite-weight gain
Thinning of the skin
Slow withdrawal (tapering) when stopping meds to wake the adrenal glands up
NSG considerations with glucocorticoids
Alternate day dosing
Give before 9AM
Administer with food
Can occur after anesthesia
Patient will exhibit signs of increased temp, pulse, BP, muscle spasms, etc.
treated with Danitrum (antispasmodic drug)
What is given for overdose of Morphine?
What is given for overdose of Tylenol?
Agonist/antagonist drug example:
Could lose autotnomous function
monitor patient for voiding
Who can give anesthesia?
CRNA or anesthesiologist
combination of drugs to accomplish multiple things in the body
Example: using inhalation & IV
Neuromuscular blocking agents used with inhalation anesthesia