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Pain Meds 3
| Question | Answer |
|---|---|
| Fenamate hx investigation? | previous peptic ulcer drug usage |
| Who should use Piroxicam? | patients with long term arthritis |
| Why choose Proxicam over other meds? | Longer ½ life and taken once a day; tolerated better than other arthritis meds |
| S/E of Celecoxib | "N/V/D, peripheral edema, HA, dizzy, flatulence, sinusitis" |
| Teaching: Celecoxib | "increase fluids, adhear to dosage, call MD; abd pain, black tarry stools, skin rash, unexplained weight gain, edema, chest pain or s/s hepatoxicity; notify HPC if pregnant" |
| Nursing assesment for Celecoxib | "asses ROM; allergies; lab: AST, ALT, BUN" |
| "while on celecoxib, pt should increase/decrease fluids?" | increase/encourage |
| Herbs that increase bleeding? | "Fever few, Dong Qui, Garlic, Ginko, Ginger" |
| What are celecoxib used for? | short term conditions |
| S/E of steroid medications | "excess hair, angry, hungry, increased glucose, increased weight gain" |
| Methotrexate is used for | "Immune suppressants, cancer growth, and suppress rheumatoid arthritis" |
| How does infliximab work? | disrupts inflamatory response |
| teaching: immunomodulator meds | increase in infection; expensive; contraindicated in active infections |
| antimalarial drugs are used for? | "rheumatoid arthritis, with NSAIDs who’s arthritis is not under control" |
| when to see results from antimalarias? | 4-12 weeks |
| can antimalarials be used with NSAIDs? | yes |
| if you have gout you can not have what foods? | "beer, organ meats, sardines, salmon, gravey, herring, liver, meat soups" |
| what is gout? | "inflammation of joints, tendons and tissue; defect in purine metabolisim causing uric acid build up-most common in the big toe |
| Cochicine’s action? | inhibit migration of leukocytes to inflamed sites; keeps body from reacting to gout flare ups |
| Cochicine teaching | take with food |
| who should not take cochicine? | "sever renal, cardiac patients, or if you have renal problems" |
| what is Cochinine used for: | acute gout; not used for long term |
| Action of Allopurinol | decrease uric acid; prophylactic for gout issues |
| labs to monitor with Allopurinol | AST, alt, BUN |
| Pt. teaching for allopurinol | "yearly eye exams, avoid: alcohol, caffeine and thiazied diuretics, dz process; community health nurse; increase fluids; keep all related medical appts, increases effects of warfarin and hypoglycemic meds |
| why does the patient not eat specific foods | increases uric acid levels; exaserbates gout |
| pt with gout and renal issues should use what med to treat gout? | Allopurinol |
| probenecid and sulfipyraxone are used for? | chronic gout |
| s/e for uricosurics: probenecide and sulfpyraxone | "gi upset flushed skin, sore gums, HA, kidney stones" |
| nursing interventions for uricosurics | "increase fluids, avoid asprin," |
| should patients increase or decreased fluids? | increase |
| Pt teaching for NSAIDs | "s/e, diet, take with food at meal time with full glass of liquid; monitor for excessive bleeding with in the first couple days of period" |
| Theraputic level for acetaminophen | 10-25 |
| labs to monitor with acetaminophen | "liver, renal, cbc" |
| antidote for acetaminophen | ascetylcysteine |
| early s/s for acetaminophen toxicity | "n/v/d, abd pain" |
| opioid analgesics used for? | Mod – sever pain |
| Unexpected therapeutic effects of opioid analgesics | "antidirrheal, cough suppressant" |
| s/e of opioid analgesics | "n/v, constipation, ortho hypo, dpression, urinary retention, respriitory depression, antitussive" |
| OTC hers/medications to avoid while on opioids | "kava kava, valerian, st. johns wort" |
| s/e to monitor for with morphine | "resp. depression, ortho hypo, constipation, urinary retention, cough suppression" |
| antidote for morphine | naloxone |
| which last longer; morphine or meperidoine | morphine |
| contraindications of meperidione | "Chronic pain, severe liver dysfunction, sickle cell, seizures, CAD, dysrhythmias" |
| monitoring for meperidine | "liver, bp, nephrotoxicity" |
| max dose and time frame for meperidine | 600 mg/24hr; do not take longer than 48-72 hours |
| what is more potent: morphine or hydromorphone? | hydromophone-6x’s more potent but has a shorter duration |
| what should the nurse monitor for hydromophone? | "v/s, withdrawl, i/o cardiac monitoring" |
| who can not use hydromorphone? | "head injury, chronic resp., shock r/t decreased BP" |
| what is the advantage to combo drug; opiod and NSAIDs | less dependency from long term opioid usage |
| 3 common meds used in PCA’s | morphine fentanyl hydramophine |
| what is hydromophone? | semi-synthetic opiod; faster on set and shorter duration |
| s/e for hydomophone | "resp. depression, ortho hypo, constipation, drowziness, pupillary retention, tolerance and dependance" |
| what does with drawl look like? | "irriable, sweating, restlessness, muscle twitching, increase in pulse and bp" |
| when is hydramophone contraindicated? | "head injury, chronic resp disorder, shock, hypotention" |
| Family teaching for a PCA | there is a lock out time; and admin is near constant administration |
| advantages of transdermal opioid analgesic rout | provides continuous pain control for chronic pain |
| purpose of opioid agonist-antagonists | decrease abuse; safer during labor; narcan is added to decrease chances of abuse |
| what are the meds in the opioid agonist-antagonist group: | "penaxocine, butorphanol, bupernorphine, nubane" |
| who can use opioid agonist-antagonist drugs: | "Non-cancerous patients, but safe during labor" |
| how does the antidotes for opioids work: | blocks receptor site for opioid |
| how do you know that opioid agonist have worked? | reversal of resp. and CNS depression |
| Labs to be monitored with naloxalone | "pt, ptt, increased bleeding for the patient" |
| family teaching for s/e of naloxone | Tachycardia, sweating, n/v increased bleeding |
| pt monitoring for naloxone | "v/s, bleeding; may need repeated dosing" |
| difference between migraines and cluster HA | "migraine: unilateral, throbbing pain that disrupts ADL’s; cluster HA: non-throbbing, multiple at one time" |
| common triggers for migraine's | "chocolate, smoking, HTN, cheese, red wine" |
| migraine patho | inflammation and dilation of blood vessels and imbalance of serotonin |
| s/e of sumatriptan | "dizzy, tingling, numbness, warmth, drowsy, seizures, arrhythmia, thrombosis, MI, stroke" |
| teaching: sumatriptan | "only use during attack, 1h between dosages, no more than 2 injections in 24 hrs; avoid dring; call HCP: IF CHEST PAIN, SWEATING, sob" |
Created by:
sparker77
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