BC Nursing: Pharm S1 - Analgesics

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Codeine

Therapeutic Class?
Pharmacologic Class?

T: Opioid Analgesic

P: Opioid Agonists

Codeine

Main Action

Binds to opiate receptors in the CNS.

Alters the perception of and response to painful stimuli while producing generalized CNS depression.

Codeine

Indication

To treat mild to moderate pain.

To treat cough from chemical or mechanical irritation of respiratory system.

Codeine

Side Effect/Adverse Reaction

CNS: Sedation, Dizziness

CV: Bradycardia, Hypotension

EENT: Blurred Vision, Dry Mouth

GI: Constipation, Nausea, Vomiting

GU: Urine Retention, Urinary Hesitation

RESP: Respiratory Depression, Apnea

SKIN: Flushing, Urticaria, Pruritus

Codeine

Assessments/Implementation/Evaluation

Assess type, location, and intensity of pain before and 1 hour after administration.

Assess blood pressure, pulse, respiration before and periodically during administration.

Notify prescriber immediately if respiration below 10.

Assess urine output to detect retention.

Assess bowel function routinely due to constipation.

Decrease in severity of pain without a significant alteration in LOC or repiratory status.

Codeine

Patient Teaching

Take exactly as prescribed.

Avoid alcohol and other CNS depressants during drug therapy.

To minimize nausea, suggest that patient take with food.

Avoid potential hazardous activities during morphine therapy.

Report shortness of breath or difficulty breathing.

Change position slowly.

Morphine

Therapeutic Class?
Pharmacologic Class?

T: Opioid Analgesic

P: Opioid Agonists

Morphine

Main Action

Binds to opiate receptors in the CNS.

Alters the perception of and response to painful stimuli while producing generalized CNS depression.

Morphine

Indication

Relieve acute or chronic moderate to severe pain.

Pulmonary edema.

Pain associated with MI.

Morphine

Side Effect/Adverse Reaction

CNS: Sedation, Dizziness

CV: Bradycardia, Hypotension

EENT: Blurred Vision, Dry Mouth

GI: Constipation, Nausea, Vomiting

GU: Urine Retention, Urinary Hesitancy

RESP: Repiratory Depression, Apnea

SKIN: Flushing, Urticaria, Pruritus

Morphine

Assessments/Implementation/Evaluation

Assess type, location, and intensity of pain before and 1 hr after administration.

Assess blood pressure, pulse, respiration before and periodically during administration.

Notify prescriber immediately if respiratory rate drops below 10 breaths per minute.

Assess urine output to detect retention.

Assess bowel function routinely due to constipation.

Decrease in severity of pain without a significant alteration in LOC or respiratory status.

Morphine

Patient Teaching

Take exactly as prescribed .

Avoid alcohol and other CNS depressants during drug therapy.

To minimize nausea, suggest that patient take with food.

Avoid potential hazardous activities during morphine therapy.

Report shortness of breath or difficulty breathing.

Change position slowly.

Narcan (Naloxone)

Therapeutic Class?
Pharmacologic Class?

T: Opioid Antidote

P: Opioid Antagonist

Narcan (Naloxone)

Main Action

Competitively blocks the effects of opioids, including CNS and respiratory depression, without producing any agonist

Narcan (Naloxone)

Indication

To treat known or suspected opioid overdose.

To treat postoperative opioid-induced respiratory depression.

Narcan (Naloxone)

Adverse Reaction

CNS: Somnolence, Anxiety, Confusion

CV: Hypertension, Tachycardia

EENT: Dry Mouth, Blurred Vision

GI: Constipation, Nausea, Vomiting

GU: Urinary

Narcan(Naloxone)

Assessments/Implementation/Evaluation

Administer for respiratory rate below 10.

Monitor for nausea, abdominal pain, anorexia, dizziness and drowsiness.

Assess for the presence/Hx of bleeding disorders, gastric ulcers, severe renal/hepatic disease.

Assessment of the location, character and intensity of pain, should be done initially for baseline date and throughout treatment to determine effectiveness.

Adequate ventilation - alertness without significant pain or withdrawal symptoms.

Narcan (Naloxone)

Patient Teaching

As medication becomes effective, explain purpose and effects for Narcan to client.

Aspirin (ASA)

Therapeutic Class?
Pharmacologic Class?

T: Nonopioid Analgesic, Antipyretic

P: Salicylates

Aspirin (ASA)

Main Action

Produce analgesia and reduce inflammation and fever by inhibiting the production of prostaglandins.

Aspirin (ASA)

Indication

Inflammatory disorders including rheumatoid arthritis, osteoarthritis, mild to moderate pain, fever.

Prophylaxis of TIA and MI.

Aspirin (ASA)

Side Effect/Adverse Reaction

Confusion, hearing loss, tinnitus, GI bleeding, heartburn, hepatotoxicity, thrombocytopenia, prolonged bleeding time, Reye's syndrome.

Aspirin (ASA)

Assessments/Implementation/Evaluation

Don't crush timed release of controlled release aspirin tablet unless directed.

Ask about tinnitus. This reaction usually occurs when blood aspirin levels reaches or exceeds maximum for therapeutic effect.

Effective in treatment of mild to moderate pain.

Aspirin (ASA)

Patient Teaching

Advise parents not to give to a child or adolescent with chicken pox or flu symptoms because of risk of Reye's syndrome.

Advise adult patient taking low-dose aspirin not to take ibuprofen because it may reduce the cardio-protective and stroke preventive effects of ASA.

Instruct patient to take ASA with food or after meals because it may cause GI upset.

Tell patient to consult doctor before taking ASA with any prescription drug for blood disorder, diabetes, gout or arthritis.

Motrin (Ibuprofen)

Therapeutic Class?
Pharmacologic Class?

T: Nonopioid Analgesic, Antipyretic

P: Analgesic, Anti-Inflammatory, Antipyretic

Motrin (Ibuprofen)

Main Action

None Given

Motrin (Ibuprofen)

Indication

To relieve pain in rheumatoid arthritis and osteoarthritis.

To relieve mild to moderate pain.

To relieve acute migraine pain.

To relieve minor aches, pains, and reduce fever dysmenorrhea.

Motrin (Ibuprofen)

Side Effect/Adverse Reactions

Epigastric discomfort, GI bleed, hepatic failure, thrombocytopenia, anemia, prolonged bleeding time, bronchospasms.

Motrin (Ibuprofen)

Assessments/Implementation/Evaluation

Use with extreme caution in patients with a history of ulcer disease or GI bleeding.

Elderly are at greater risk for GI problems.

Give with food.

Drug may cause hypertension or worsen it.

NSAIDs increase risk of events such as MI and stroke.

Control of mild to moderate pain, fever, and various inflammatory conditions.

Motrin (Ibuprofen)

Patient Teaching

Instruct patients to take with full glass of water.

Take drug with food or after meals.
Urge patient to not take more than prescribed.

Advise patient to avoid taking two different NSAIDs at the same time, unless directed.

Urge patient to avoid alcohol, aspirin and corticosteroids while taking this med unless prescribed.

Advise patient to report flu-like symptoms, rash, signs of GI bleeding, swelling, vision changes, and weight gain.

Tylenol (Acetaminophen)

Therapeutic Class?
Pharmacologic Class?

T: Nonopioid Analgesic, Antipyretic

P: Non-Narcotic Analgesic, Antipyretic

Tylenol (Acetaminophen)

Main Action

Acts directly on temperature regulating center in the hypothalamus.

Tylenol (Acetaminophen)

Indication

Relieve mild to moderate pain associated with headache, muscle ache, back ache, minor arthritis, common cold, toothache, and menstrual cramps, to reduce fever.Interferes with pain impulse generation.

Tylenol (Acetaminophen)

Side Effect/Adverse Reaction

Abdominal pain, hepatotoxicity, thrombocytopenia, jaundice.

Tylenol (Acetaminophen)

Assessments/Implementation/Evaluation

Before, and during long-term therapy monitor liver function and renal function tests.

Expect to reduce dosage for patient with renal dysfunction.

Effective in treatment of mild to moderate pain.

Tylenol (Acetaminophen)

Patient Teaching

Read manufacturers label and follow dosage guidelines precisely.

Teach patient to recognize signs of hepatotoxicity, such as bleeding, easy bruising and malaise.

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