Exam (elaborations)
Pharmacology For Nursing Practice (NR-293)Pharm_Exam_2.
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- Chamberlain College Nursing
Pharmacology For Nursing Practice (NR-293)
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Pharm Exam 2Chapter 10 - Analgesic Drugs (-profen / -adol / -one / -done)
● Morphine
○ Drug action: binds to opiate receptors in the CNS. alters the perception of and
response to painful stimuli while producing generalized CNS depression (toxicity
can occur in patients with renal impairment)
○ Therapeutic indication: indicated for severe pain and has a high abuse potential.
Decrease in severity of pain.
○ Administration: available in a variety of routes (subcutaneous, IM, PO, IV,
extended/immediate release) always monitor respiratory rate
○ Side effects
■ CNS: confusion, sedation, dizziness, hallucinations, headache
■ EENT: blurred vision
■ Resp: RESPIRATORY DEPRESSION
■ GI: constipation, nausea, vomiting, urinary retention
■ Skin: flushing, itching, sweating
■ Other: physical dependence, psychological dependence, tolerance
○ Patient education: CNS: confusion, sedation, dizziness, hallucinations, headache
● Dosage adjustments for when the patient is taking multiple narcotics
○ For patients taking more than one opioid, the equivalent doses of the different
opioids must be added together to determine the cumulative dose
● Demerol
○ Drug action: effects the CNS and smooth muscle to help them relax. Resembles
morphine
○ Therapeutic indications: opioid pain medication. Is used to treat moderate to
severe pain
○ Administration: IM, IV, and oral
○ Side effects: respiratory depression, habit forming, dry mouth, lightheadedness,
N/V, sweating, constipation
○ Patient educationv
■ Do not take with alcohol
■ Taking this medication during pregnancy may cause life threatening
withdrawal symptoms in a newborn
● Long term use of demerol
○ Not recommended because of the unpredictable effects of neuro metabolites at
analgesic doses and seizure risk
● Lidocaine (lidoderm patch)
○ Drug action: blocks both initiation and conduction of nerve impulses
○ Therapeutic indications
○ Administration: topical patch
○ Side effects
■ Hypotension, nausea
■ Serious: cardiac dysrhythmia/arrest, anaphylaxis
○ Patient education
■ May cause skin irritation
■ Do not apply to broken or irritated skin
● Assessment and treatment of opioid overdose
, ○ Naloxone (Narcan) and naltrexone can reverse adverse effects such as
respiratory depression
○ Withdrawal symptoms: anxiety, fatigue, sweating, vomiting, depression, seizures,
and hallucinations
● Considerations for patient safety and nursing assessments in the administration of
narcotics
○ Known drug allergies
○ Severe asthma
○ CNS depression - leads to respiratory depression
○ Treat pain before it becomes severe
● Narcotic tolerance
○ Repetitive exposure, over time, induces changes in drug receptors that reduce
the drug's effects
○ Increased likelihood of withdrawal symptoms in abrupt discontinuation
Chapter 11 - General and Local Anesthetics (-ane / -caine)
● Malignant hyperthermia
○ Genetically linked adverse reaction to anesthesia
○ Rapid rise in body temperature with tachycardia, tachypnea, and sweating
● Succinylcholine expected effects--- succinylcholine is a depolarizing neuromuscular
blocker that has a high incidence of malignant hyperthermia as a complication. Monitor
for rapid rise in body temperature with tachycardia, tachypnea, and sweating
● Consider important nursing assessments and interventions when caring for patients
■ Use caution in elderly - cardiac and respiratory problems, polypharmacy,
declining liver function
■ Neonates at higher risk of upper airway obstruction
■ Drug interactions: antihypertensives and beta blockers
■ Check vitals, gag reflex, orientation
○ Before anesthesia (preanesthesia)
■ Patient education about procedure
■ Vital signs
■ Lab work/EKG
■ ABC’s
■ Monitor body systems
○ During anesthesia
■ Monitor vital signs and ABC’s
■ Watch for sudden elevations in body temperature (malignant
hyperthermia)
○ After anesthesia (postanesthesia)
■ Monitor for cardiovascular depression and complications of anesthesia
■ Implement safety measures, especially if motor or sensory loss occurs
■ Teach patient about post-op turning, coughing, and deep breathing
● Herbal products and surgery
○ Assess patient's level of homeostasis
○ Can increase sedating effects, bleeding, adverse cardiac effects
○ Always be cautious with herbal supplements when taken with anticoagulants
Chapter 12 - Central Nervous System Depressants and Muscle Relaxants (-zepam
-barbital)
, ● Indications for giving sedatives and hypnotics
○ Sedatives: inhibitory effect on the CNS, reduces nervousness, excitability and
irritability without causing sleep
○ Hypnotics: given in low to moderate doses. Calms and soothes the CNS, at high
doses can cause sleep
● Patient education for sleep aid medication
○ Ensure a sleep schedule is followed
○ Some sleep aids can leave you feeling groggy and unwell the next day
○ Medication interactions are possible
● Benzodiazepines
○ Drug action: anticonvulsant and muscle relaxant
○ Therapeutic indications: used to treat anxiety, muscle spasms, and seizures
○ Administration: usually orally, but can also be given IV for treatment of panic
attacks
○ Side effects: CNS depression, allergy, seizures, confusion, lethargy, nausea,
lightheaded, or dizziness
○ Patient education:
■ Too much of this drug will cause death
■ Don’t use if you are pregnant, breastfeeding, or have liver or kidney
disease
■ This drug is habit forming
● Diazepam (Valium)
○ Drug action: reduces neuronal depolarization resulting in decreased action
potentials
○ Therapeutic indications: treats anxiety, for procedural sedation and anesthesia
adjunct, anticonvulsant therapy and skeletal muscle relaxation after orthopedic
injury or surgery
○ Administration: enteral, IM, IV, oral, rectal
○ Side effects: hypotension, rash, diarrhea, muscle weakness, ataxia,
incoordination, euphoria, respiratory depression, fatigue, neutropenia
○ Patient education
■ Avoid activities that require mental alertness or coordination
■ Avoid abrupt discontinuation of drug to prevent withdrawal
■ Do not drink alcohol while taking this medication
● Lorazepam (Ativan)
○ Drug action: exerts tranquilizing action on the CNS with no effect on the
respiratory or cardiovascular system
○ Therapeutic indications: antianxiety, sedative, and anticonvulsant
○ Administration: IM, IV, oral
○ Side effects: physical weakness, lack of energy, dizziness, sedation,
unsteadiness, depression, acidosis , delirium
○ Patient education
■ Avoid activities that require mental alertness or coordination
■ Avoid during pregnancy
■ Do not suddenly discontinue drug
■ Avoid alcohol and other CNS depressants
● Benzodiazepine safety with the older adult
○ Long term use can lead to dependence
○ Impair cognition, mobility, and driving skills in older people, as well as increase
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