BCTC Nursing Pharmacology Comfort/Mobility Agents

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Morphine sulfate

Class: Opioid Analgesic
Uses: Moderate to severe pain
Action: Depresses pain impulse transmission at the spinal cord level by interacting with opiod receptors
Nursing Considerations: May cause constipation, watch for orthostatic hypotension, watch for respiratory depression, treat overdose with Narcan (Naloxone)

Oxycodone (Tylox, Roxicet, Percocet)

Class: Opiate analgesic
Uses: Moderate to severe pain
Action: Inhibits ascending pain pathways in CNS, increases pain threshold, alters pain perception
Nursing Considerations: May cause constipation, watch for orthostatic hypotension, watch for respiratory depression, treat overdose with Narcan (Naloxone)

Meperidine (Demerol)

Class: Opioid analgesic
Uses: Moderate to severe pain, preoperative, postoperative; off-label for obstetric/regional analgesic, acute severe headache, postoperative shivering
Action: Depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors

Naloxone (Narcan)

Class: Opioid antagonist
Uses: Respiratory depression induced by opiods, pentazocine, propoxyphene; refractory circulatory shock, asphyxia neatorum, coma, hypotension; off-label for IBS, opiate agonist dependence, urinary retention
Action: Competes with opiods at opiate receptor sites
Nursing Considerations: Keep resuscitative equipment, O2 nearby. Frequent vitals, may cause seizures. Pt may become delirious. Aspiration precautions due to poss. vomiting.

Ketorolac (Toradol)

Class: Non-steroidal anti-inflammatory, nonopioid analgesic
Uses: Mild to moderate pain (short-term); seasonal allergic conjunctivitis (ophthalmic)
Action: Inhibits prostaglandin synthesis by decreasing an enzyme needed for biosynthesis; analgesic, anti-inflammatory, antipyretic effects
Nursing Considerations: Watch for blurred vision, tinnitus and jaundice which may indicate toxicity

Butorphanol Tartrate (Stadol)

Class: Opioid analgesic; mixed opioid antagonist, partial agonist
Uses: Moderate to severe pain; migraines, as a supplement for balanced general anesthesia, and management of pain during labor
Action: Depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors

Hydrocodone (Lortab, Vicodin)

Class: Antitussive opioid analgesic
Uses: Hyperactive and nonproductive cough, mild-moderate pain
Action: Acts directly on cough center in medulla to suppress cough; binds to opiate receptors in CNS to reduce pain

Acetaminophen (Tylenol)

Class: Nonopioid analgesic, antipyretic
Uses: Mild to moderate pain, fever, arthralgia, dental pain dysmenorrhea, headache, myalgia, osteoarthritis, migraine
Action: May block pain impulses peripherally that occur in response to inhibition of prostaglandin synthesis; no antiinflammatory properties; antipyretic response due to inhibition of prostaglandins in the CNS
Nursing Considerations: Hepatotoxicity

Aspirin

Class: Nonopioid analgesic, nonsteroidal antiinflammatory antipyretic, antiplatelet
Uses: Mild to moderate pain or fever, including RA, osteoarthritis, thromboembolic disorders, TIAs, rheumatic fever, post-MI, prophylaxis of MI, ischemic stroke, angina
Action: Blocks pain impulses in CNS. Reduces inflammation by inhibition of prostaglandin synthesis; antipyretic action results from vasodilation of peripheral vessels; decreases platelet aggregation.
Nursing Considerations: Hepatoxicity, Ototoxicity (tinnitus), Allergic reactions may occur, may cause GI bleeding/heartburn administer with milk or food

Baclofen (Lioresal)

Class: skeletal muscle relaxant, central acting
Uses: Spacticity in spinal cord injury, multiple sclerosis, neuropathic pain, trigeminal neuralgia, recurrent priaprism
Action: Inhibits synaptic responses in CNS by stimulating GABab receptor subtype, which decreases neurotransmitter function; decreases frequency and severity of muscle spasms
Nursing Considerations: Can cause increased seizure in epileptic patients, do not stop suddenly, may lead to hallucinations, spasticity, and tachycardia

Allopurinal (Zyloprim)

Class: Antigout drug, antihyperuricemic
Uses: Chronic gout, hyperuricemia associated with malignancies, recurrent calculi
Action: Inhibits the enzyme xanthine oxidase, reducing uric acid synthesis

NSAIDS (ibuprofen)

Class:NSAID, antipyretic nonopioid analgesic
Uses: Rheumatoid arthritis, osteoarthritis, gout, dental pain, musculoskeletal disorders, fever
Action: Inhibits prostaglandin synthesis by decreasing enzyme needed for biosynthesis; analgesic antiinflammatory, antipyretic

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