Pain & Inflammation
pa * Med for Pain *
3
Therapy
categories of med to x pain
-
① Nonopioid analgesics
② Opioid analgesics
③ Opioid antagonists
·
Nonopioid Analgesics
· NSAIDS (Cox 112 Inhibitors -
>
suppress inflammation
>
reduce fever
X mild-mod pain relieve dysmenorrhea
.
>
*
Aspirin inhibits platelet aggregation (anticoagulant
:
↳
give for prophyOf thrombi
Ibuprofen (Advil/Motrin) ; Aspirin ; Naproxen ; indomethacin Ketorolac meloxicam; , ,
diclofenac
Action :
inhibits action of COX
-
1st NSAID : Blocks COX1 & 2
gen
-
-
Adverse Reactions :
Gastric upset ,
heartburn nausea
, ,
gastric ulcers ,
bleeding , renal issues,
Reyes Syndrome (child &10)
↳ cause liver a
Confusion Seizures loss of consciousness brain damage death
3 vomiting
-
, . , ,
+X w diuretics &
electrolytes
Interventions : Mon for bleeding (black/dark stools
- -
Mon for abdominal pain nausea hemalemesis (vomit blood ,
,
Test forI pylori
-
.
-High risk pts for gastric bleed => Proton Pump inhibitor
Monpetechiae (pinpoint & easy bruising of easy bleeding
Y
A
Mon & 190 BuNd , creatinine & ,
-
Mon for tinnitus ,
dizziness , $/or headache , diaphoresis (Sweating) tachypnea ,
# for short
*
use period of timeI a dose
u
S Administration Stop Aspirin I before
week surgery
-
-
Usually Aspirin =
S1mg/day
g Pt Education
-
take we food milk , ,
or 802 water
-Avoid alcohol
Report Gl Irritation bleeding (bruising petechiae coffee-ground emesis (
-
, ,
,
f change in output weight gain edemal bloating , ,
Y -
Not for 18 luse acetaminophen)
-
Report Chest pain heaviness SoB (M1)
-
, ,
--
Report sudden / severe headache . One sided numbness weak Visual disturb.
-
, ,
# Confusion (Stroke
Report tinnitus immed ! Sweating headache dizziness
-
,
,
, ⑭
·
NSAIDs (Cox .
2 Inhibitors (
> x mild to mod pain ↳ ↓ fever
suppresses inflamm .
Stydysmenorrhea pain
& celecoxib
-AdverseReactiona eartburn
> less than
I
diarrhea Gl Ulcers wi coxt
-
-
renal dysf .
-
cardio/cerebro events
8 -
Interventions
-
monitor GI upset heartburn nausea diarrhea. Gl bleed
-
, ,
,
- -test &+X H .
Pylori
-
- poss PPI .
F
=
Monitor 190 BUN creatinine ,
,
-only use for short time ↓ dose
use low dose aspirin if using NSAID
long term
=
-
Administration
-give 2hrs before or after antacid
· -
Pt Education
-use low dose Aspirin to
d risk of M or stroke
take WI food milk or 802 water
-
, ,
avoid alcohol
-
-
report persistant GI upset manifest of GI bleed change in output weight gain edema,
-
or
·
, ,
,
bloating .
Chest pain/heaviness ,
sob , sudden severe headache numbness , ,
weak,
- visual disturb confusion ,
E
3 ractions
·
Furosemide (d effects)
Fluconazole 14 celecoxib levels)
·
·
it effects of warfarin
·
Acetaminophen
< X mild to mod > ↓ fever
.
Pain
Acetaminophen
-
Action :
Similar to COX ; effets limited to CNS
* No
antiinflammatory or
anticoagulant effect
Adverse ,
Reactions
-
liver damage
-
HTN (after long period
-
