Nr - 293 Pharmacology Exam 2 :
Units 3 And 4 2023 /329
Questions And Answers (A+)
Quiz :What are analgesic drugs? - √Answer :Pain killers that
relieve pain without causing loss of consciousness.
Quiz :What are the 2 different class of analgesics? -
√Answer :opioids analgesics and adjuvant analgesics
Quiz :What factors changes a person's perception of pain? -
√Answer :Varies by attitude, environment, culture, ethnicity
Past experience, anxiety, past experience, gender, general
mental health
Quiz :A patient with bone cancer tells the nurse that he is in
pain. The nurse knows that bone pain is classified as which
type of pain?
a. Somatic pain
b. Referred pain
c. Visceral pain
d. Neuropathic pain - √Answer :a. Somatic pain, which includes
bone pain, originates from the skeletal muscles, ligaments, and
joints. Referred pain occurs when visceral nerve fibers synapse
at a level in the spinal cord close to fibers that supply specific
subcutaneous tissues in the body. Visceral pain originates from
organs and smooth muscles. Neuropathic pain usually results
from damage to peripheral or CNS nerve fibers or injury, but
may also be idiopathic.
Quiz :What are adjuvant drugs? - √Answer :Are drugs that
assist primary drug in relieving pain such as NSAIDs,
antidepressants, antiepileptics, and corticosteriods
,Quiz :Describe the WHO three-step analgesic ladder - √Answer
:Step 1: nonopioids (with or without adjuvant medications) after
the pain has been identified and assessed. If pain persists or
increases, treatment moves to
Step 2: opioids with or without nonopioids and with or without
adjuvants. If pain persists or increases, management then rises
to
Step 3: opioids indicated for moderate to severe pain,
administered with or without nonopioids or adjuvant
medications.
Quiz :What is the opiod ceiling effect? - √Answer :Drug reaches
a maximum analgesic effect
Analgesia does not improve, even with higher doses
Quiz :What are the 3 classifications of opiods? -
√Answer :Agonist, Agonists-antagonist, antagonist
Quiz :why is meriperidine not recommend for long term use? -
√Answer :Accumulation of neurotoxic metabolite -
normerperidine which causes seisures
Quiz :What is the mechanism of Agonist? - √Answer :Bind to
an opioid pain receptor in the brain
Cause an analgesic response (reduction of pain sensation)
Quiz :What is the mechanism of Agonist-antagonist? - √Answer
:Bind to a pain receptor
Cause a weaker neurologic response than a full agonist
Exert their effect by binding in different degrees to kappa + mu
opiod receptors
Not usually first like pain treatment
Used in OB patients to provide pain relief to mom without
sedating fetus
,Quiz :What is the mechanism of antagonist? -
√Answer :Competes with and reverses effect of agonist and
agonist-antagonist drugs at receptor site
Quiz :What are the indications for opiod analgesics? - √Answer
:Main use: to alleviate moderate to severe pain
Often given with adjuvant analgesic drugs to assist primary
drugs with pain relief
Opioids are also used for:
Cough center suppression
Treatment of diarrhea-Imodium
Balanced anesthesia
Quiz :What are the contraindications for opiod analgesics? -
√Answer :Known drug allergy
Severe asthma
Use with extreme caution in patients with:
Respiratory insufficiency
Elevated intracranial pressure
Morbid obesity or sleep apnea
Paralytic ileus
Pregnancy
Quiz :A patient is recovering from an appendectomy. She also
has asthma and allergies to shellfish and iodine. To manage
her postoperative pain, the physician has prescribed patient-
controlled analgesia (PCA) with hydromorphone (Dilaudid).
Which vital sign is of greatest concern?
Pulse
Blood pressure
Temperature
Respirations - √Answer :Correct answer: D
, Rationale: This patient has a history of asthma and allergies,
and she will be receiving a drug that can depress respirations.
Quiz :Adverse effects of Opiod analgesics? - √Answer :CNS
depression
Leads to respiratory depression
Most serious adverse effect
Nausea and vomiting - irritation of GI tract stimulates
chemoreceptors zone in CNS.
Urinary retention
Diaphoresis and flushing
Pupil constriction (miosis)
Constipation - slows peristalsis and increase water absorption
from intestinal contents.
Itching
Strong affinity for mu receptors for rapid onset and produce
euphoria which leads to high addiction.
Cause histamine relaease -> itching, rash, hemodynamic
changes, flushing and orthostatic hyper tension
Quiz :A patient who has metastasized bone cancer has been
on transdermal fentanyl patches for pain management for 3
months. He has been hospitalized for tests and has told the
nurse that his pain is becoming "unbearable." The nurse is
reluctant to give him the ordered pain medication because the
nurse does not want the patient to get addicted to the
medication. The nurse's actions reflect
appropriate concern for the patient's best welfare.
appropriate caution for a patient who is already on a long-term
opioid.
an uncaring attitude toward the patient.
a failure to manage the patient's pain properly. -
√Answer :Correct answer: D
Rationale: Patients with severe pain, including metastatic pain
or bone pain, may need higher and higher doses of analgesics.
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