Study guide
- Course
- Institution
NR-291 Pharmacology I Exam 4 Study Guide
[Show more]
Seller
Follow
PerfectStudy
Reviews received
Content preview
1NR-291 Pharmacology I Exam 4 Study Guide
Chapter 10: Analgesic Drugs
o Know and apply basic pharmacology principles for pain management
o Know WHO Analgesic Ladder and apply to acute pain and chronic pain management
o Opioid Drugs: 1, 5, 6, 11, 12, 13 (addicts and non-addicts)
Nice to know:
Nursing Considerations:
o Medicate pts before the pain becomes severe (Around the Clock,
ATC)
o Pharmacologic and nonpharmacologic approaches to pain
o Oral forms should be taken with food to minimize gastric upset
o Ensure safety measures such as keeping side rails up, to prevent
injury
Drug Interactions:
o Alcohol, antihistamines, barbiturates, benzodiazepines,
monoamine oxidase inhibitors
4 categories of opioids:
o Endogenous – produced by the body
o Opium alkaloids – morphine
o Semi-synthetic opioids – oxycodone, hydrocodone,
hydromorphone, heroin
o Fully synthetic opioids – propoxyphene, tramadol, pentazocine
Heroin, oxycontin, and hydrocodone/acetaminophen (Vicodin) have
similar effects
Opioid ceiling effect – codeine, nalbuphine, pentazocine
Clonidine
o Alpha-2 adrenergic agonist
o Central inhibition of the hyper-nonadrenergic state that occurs in
opioid withdrawal
o Decrease BP and stress in the first few days of withdrawal
Good to know:
Rapid-onset opioids (fentanyl)
o Do not have to swallowed (injection, buccal lozenge, or
stick/sucker)
o Approved for treatment of cancer-related breakthrough pain
o Patches change every 72 hours
Dispose by flushing down toilet or sharps container, avoid
heat over patch because can increase absorption
Use with extreme caution in pts with:
o Respiratory insufficiency, elevated intracranial pressure, morbid
obesity and/or sleep apnea, paralytic ileus, pregnancy
Adv Eff:
o CNS depression
Leads to respiratory depression, most serious adv eff
Decreased BP and HR
Sleepiness
o GI
, 2
Nausea and vomiting
Paralytic ileus
Constipation (Opioid Induced Constipation/ OIC) –
adequate fluid and fiber intake to prevent
Methlnaltrexone bromide (Relistor)
Lubiprostone (Amitiza)
o GU
Urinary retention
o Skin
Diaphoresis, flushing, and itching
o Eyes
Pupil constriction (miosis)
Hydromorphone
o 8 times more potent than morphine
o Epidural route can lead to increased ICP
Got to know:
Opioid antagonist drug: naloxone
o Given IV push
o Reverse adv eff of opioid drugs
Withhold dose and contact physician if there is a decline in
the pt’s condition or if vital signs are abnormal, especially
if respiratory rate is less than 10-12 breaths/min
Regardless of symptoms, when a pt experiences severe
respiratory depression (dyspnea, diminished breath sounds,
or shallow/irregular breathing) give opioid antagonist
o Reversal agent for opioid addicts: naltrexone
Opioid withdrawal/opioid abstinence syndrome
o Peak 1-3 days; duration 5-7 days
o Manifested as: increased BP and HR, anxiety, irritability,
confusion, insomnia, chills, hot flashes, diaphoresis, joint pain
(arthralgia), lacrimation, rhinorrhea, nausea, vomiting, abd cramps,
diarrhea, mydriasis, piloerection
Medication treatment for withdrawal
o Clonidine (Alpha 2 Agonist)
o Methadone
Long half-life, may lead to overdose/death
Opioid so fills the same receptors of abused opioid, but
block the effects of street drugs and decreases cravings
Meperidine HCl
o Toxic CNS, may lead to seizures; not long-term therapy
adjuvant drugs: know classifications; amitriptyline: 2; gabapentin: 2
o Nonopioids: 1, 2, 3, 5
Nice to know:
Acetaminophen content of all medications taken by the pt, both OTC
(more than 600 drugs) and prescription
o Inadvertent excessive doses may occur when different combination
drug products are taken together
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller PerfectStudy. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $20.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
82215 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now