1 / 56

Analgesics and Anti-inflammatory Agents

Analgesics and Anti-inflammatory Agents. NURS 1950 Pharmacology Nancy Pares, RN, MSN Metro Community College. Obj. 1 Define pain and Pain tolerance. Pain is: Pain tolerance is:. Objective 2: Identify the factors which affect the individual’s response to pain.

Olivia
Télécharger la présentation

Analgesics and Anti-inflammatory Agents

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Analgesics and Anti-inflammatory Agents NURS 1950 Pharmacology Nancy Pares, RN, MSN Metro Community College

  2. Obj. 1 Define pain and Pain tolerance • Pain is: • Pain tolerance is:

  3. Objective 2: Identify the factors which affect the individual’s response to pain

  4. Obj. 3. Describe factors included in assessment of pain • What are the assessments? • What is included in a pain history?

  5. Objective 4: Describe scheduled drugs

  6. Obj. 4 Describe scheduled drugs • Schedule I: high potential for abuse • No accepted medical use in US • Schedule II: • high potential for abuse • Opiate analgesics

  7. Schedule III: lower potential for abuse than schedule II. • Tylenol with codeine • Schedule IV: lower potential for abuse than schedule III. • Librium, Valium

  8. Schedule V: lowest potential for abuse • Usually antidiarrheal and antitussive • Lomotil • Robitussin A-C

  9. Obj. 5 Define analgesics • What are analgesics?

  10. Obj. 6. Describe actions of narcotic analgesics • Bind to opiate receptors in the CNS • This inhibits transmission of pain impulse and alters pain perception • Also produce euphoria

  11. Some are opioid agonists • What is an agonist? • Some are agonist-antagonists

  12. Side effects of opioids • N/V • Constipation • Respiratory depression • Dependence • Tolerance

  13. When the opioids are discontinued: • Sweating, restlessness, diarrhea

  14. Signs and symptoms of overdose • Respirations under 12/minute • Pin-point pupils • Coma • What drug can be used to reverse these effects? • Why does it work?

  15. Objective 7: Compare the many effects of morphine sulfate (MS) and meperidine (Demerol)

  16. MS • Oral • Subc • IV • IM • Rectal • Sublingual • “mother” of all narcotics • Demerol • Oral • Subc • IV • IM

  17. MS • 5-20 mg dose q 4 hr • 10-60 min onset • Longer duration of action than Demerol • Demerol • 50-100 mg q 3-4 hr • 10-45 min onset • Shorter duration of action than MS

  18. Nursing Implications • Assessment of pain • Assessment of respirations • MS can be used in cancer pain • Meperidine (Demerol) metabolite is normeperidine: causes hallucinations

  19. Obj. 8 list other narcotic agents • What narcotic agents have you given?

  20. Many narcotic agents available • Given by every route • Some are only in oral form

  21. Some narcotic analgesics are • Hydrocodone + acetaminophen (Vicodin) • Fentanyl (Duragesic) • Oxycodone + ASA (Percodan)

  22. Thinking Question • A client is receiving MSContin q 12 hr-30 mg • At the next dose time, there is break through pain. • Can the client also have the MSIR dose?

  23. Obj. 9 compare narcotics with acetaminophen, asa and nsaids • Narcotics work in the CNS and affect the nociceptors (nerve endings) and the neurotransmitter pathways of pain transmission • Acetaminophen, ASA, and the NSAIDs work in the periphery and interfere with prostaglandins

  24. Nonopioid drugs are also readily available (OTC) and inexpensive • Are antipyretic and ASA and some NSAIDs have antiplatelet activity • No tolerance or dependence is caused as is the case with opiates

  25. Obj. 10 describe nursing interventions associated with narcotic administration • Double lock • Sign out • Use non-drug interventions • Assess pain • Give meds before pain severe • Don’t under treat pain

  26. Objective 11describe the use of salicylates

  27. Obj.11 describe nursing implications associated with salicylates • Peripherally acting • Interfere with synthesis of prostaglandins • What are prostaglandins?

  28. Acetylsalicylic acid (aspirin, ASA) used over 100 years • Analgesic • Antipyretic • Anti-inflammatory • Antiplatelet

  29. What are the doses for ASA? • As analgesic • As anti-inflammatory • As antipyretic • As antiplatelet

  30. Nursing Implications • Contraindicated if: on anticoagulants • if gastric ulcer • pregnancy • children with viral infections • Hypersensitive—teach client to read OTC labels

  31. Client must take adequate fluids • If GI upset, take with food or antacid • Options: buffered • enteric coated

  32. What does it mean when the label says the ASA is buffered? • What does enteric coating mean? • Can EC drugs be crushed or chewed?

  33. ASA can cause false + for glycosuria • SE: tinnitus and vertigo with high doses • Store ASA in closed, child proof container • Overdose needs prompt treatment

  34. Objective 13: identify the signs of salicylate poisoning

  35. Obj. 14 Identify the uses, advantages and major disadvantages of acetamenophen • Acetaminophen (Tylenol) • Nonopioid analgesic • Antipyretic • Available as a liquid

  36. Disadvantage of Tylenol: • Hepatotoxicity (over 4 gm/day) • Nephrotoxicity

  37. Objective 15: list some non-narcotic analgesics

  38. . • Buprenophine HCl (Buprenex) • Butophanol tartrate (Stadol) • Pentazocine HCl (Talwin) • Ibuprofen (Motrin) • Naproxin (Aleve)

  39. Question • If your client is taking Percocet and also has Tylenol ordered, what precautions will you take?

  40. Objective 16: identify some nonsteroidal anti-inflammatory agents

  41. Nonsteroidal anti-inflammatory agents modify inflammation response • Inhibit prostaglandin synthesis • Includes Aspirin as well as Motrin, Aleve, indomethacin (Indocin), oxaprozin ( Daypro), ketoralac (Toradol) • Toradol only one given IM, IV

  42. New NSAIDs are the COX-2 inhibitors • Vioxx off the market 2004 • Celecoxib (Celebrex) and its cousin Bextra under review

  43. Advantage of COX-2 inhibitors: • Less GI bleeding than other NSAIDs • Once a day or BID dosing • Disadvantages: • Can’t use if allergic • expensive

  44. Obj.17 Define gout and list drugs used in treatment • Gouty arthritis: • caused by uric acid crystals • Deposit in joints and subq tissue • Treat ASAP when acute attack occurs • Treat acute attack with colchicine • IV, oral

  45. Colchicine action • think it prevents migration of granulocytes to inflamed area so no lactic acid released

  46. Adverse effects of colchicine • N/V • Diarrhea • GI bleeding • Neuritis • Myopathy • Alopecia • Bone marrow depression

  47. Alternate treatments for gout • NSAIDs may be used for inflammation, pain and fever • Two other types of drugs used for gout • Uricosurics increase excretion of uric acid

  48. uricosurics • Adverse effects: • kidney stones can develop • Examples: probenecid (Benemid) and sulfinpyrazone (Anturane)

  49. With Benemid keep urine alkaline • No ASA • Anturane works like Benemid but also affects clotting time • Can cause GI bleeding, skin rash and blood dyscrasias

More Related