Chapter 18 Drugs for pain

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pharmacology for nurses

Opioid

Pr: morphine (Duramorph)

Action: stimulates MU and Kappa receptors

Use: analgesia, pre-anesthetic, relief of SOB, PCA pump

Ad eff: N/V, dizzy, dependance, constipation, sedation, restlessness, tolerance

Nsg C: assess for potential dependency. educate pt about PCA pump, assist w/ activity.
Monitor pain level using scale before and after.
Monitor VS= resp around the clock Hold<12, <10 give Narcan
Monitor urine output for retention, monitor BM
Monitor constipation (Narcan is the antidote)

Opiod Antagonist

Pr: naloxone (Narcan)

Action: Block MU and kappa receptor

Use: reverse respiratory depression

Ad eff: increased cardiac workload, withdrawal symptoms for opiate abusers

Nsg C: have resuscitate equipment available, assess VS and respirations q3-5min, assess pain level, monitor CV status

NSAID

Pr: Ibuprofen (Motrin)

Action: inhibit cox 1 to prevent formation of prostaglandin (pain/inflam)

use: analgesia, antipyretic, anti-inflammatory

Ad eff: GI upset, acute renal failure

NSAID salicylate

Pr: aspirin (Acetylsalicylic acid) ASA

Action: inhibits prostaglandin formation, anticoagulant activity, Cox 1 inhibitor

Use: antipyretic, analgesic, anti-inflam, anticoagulant

ad eff: GI upset, and bleeding (not to be taken w/alcohol) many increase oral hypoglycemic agents effects (lower BS)

NSAID selective Cox 2

Pr: celecoxib (Celebrex)

Action: inhibition of cox 2

Use: analgesia, antipyretic, anti-inflam. esp RA and OA

AD eff: mild GI symptoms, pain, D, dyspepsia, flatulence, N

Non-Opioid, Non-NSAID

Pr: acetaminophen (Tylenol)

Action: pain relief mechanism unknown, fever by vasodialation of vessels

Use: mild to mod pain and fever relief

Ad eff: uncommon if taken as directed, Hepatotoxic-dont take w/alcohol

Antimigraine analgesia

Pr: somatriptan (Imitrex)

Action: serotonin agonist, constricts arterial intracranial vessels

Use: abort migraines w/or w/out aura

Ad eff: GI upset
Nsg C: Quiet/calm enviro. determine intensity & frequency. Apply cold packs, assess pain lever before & after

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