Medications for Pain & Inflammation part 2

Acetaminophen therapeutic use

- used for analgesic (pain relief)

- antipyretic (reduction of fever)

Acetaminophen mechanism of action

slows production of prostaglandins

Acetaminophen complications

- rare at therapeutic dosages but can result in toxicity

- acetaminophen toxicity results in liver damage

acetaminophen toxicity results in liver damage early s/s

- nausea

- vomiting

- diarrhea

- sweating

- jaundice (yellow skin & eyes and plantar surface of hands/feet)

- abdominal discomfort leading to liver failure and death

acetaminophen contraindications/precautions

- severe liver disease or hepatic impairment

- alcohol use

- mild liver or kidney problems

- severe malnutrition

- pregnancy (IV if needed)

- lactation (use w caution)

- other medications

acetaminophen drug-drug interactions

- warfarin = ↑ anticoagulant effect = bleeds more easily

- >3 alcohol drinks/day = bleeds more easily

acetaminophen medication administration

- orally PO

- intravenous (IV)

- rectally

acetaminophen toxicity antidote

acetylcysteine

acetaminophen education

- Do not exceed 4 g/day

- Undernourished clients should not exceed 3 g/day

- Avoid alcohol

- Take with or without food

- Educate parents to consult their physician before administering to children as many OTC meds contain

acetaminophen which can

inc the risk of overdose

- Read labels

acetaminophen nursing interventions

- monitor for elevated liver enzymes ALT/AST

- monitor for medication effectiveness

- monitor for bleeding

morphine mechanism of action

- bind primarily to mu receptors to produce analgesia

- reduce inflammation thus dec pain

morphine therapeutic use

- Relief of moderate to severe pain (childbirth, post-op, heart attack, cancer)

- Sedation

- Reduction of bowel motility

- Cough suppression (codeine)

morphine complication

- respiratory depression

- cough suppression

- sedation

- constipation

- orthostatic hypotension

- urinary retention.

- biliary colic

- nausea & vomiting

- opioid overdose triad

morphine respiratory depression

- hold if RR less than 12 & notify HCP

- have naloxone available

morphine constipation

- inc PO fluids

- administer stool softener

morphine orthostatic hypotension

- monitor for dizziness or lightheadedness

- change positions slowly

morphine urinary retention

- encourage voiding q 4 hr

- monitor I&O

- asses for bladder distension

morphine opioid overdose triad

- coma, respiratory depression, pinpoint

pupils

- do careful assessments

- monitor your pt often

- be ready to think fast

Morphine Side Effects Memory Aid

- M: myosis

- O: out of it (sedation)

- R: respiratory depression

- P: pruritus (itching)

- H: hypotension

- I: infrequency (constipation, urinary retention)

- N: nausea

- E: emesis

morphine contraindications/precautions

- Premature infants during & after delivery

- Biliary tract surgery

- Extreme obesity

- Inflammatory bowel disease

- Prostate enlargement

- Hepatic or renal disease

- Pregnancy

- Infants & older adults, asthma, emphysema, head injuries

Morphine education

- Risk of drug abuse

- Turn, cough, deep breathe

- Avoid hazardous activities

- Increase fluids

- Void q4h

- monitor PCA dosing provide education to pt family

morphine drug/drug interactions

- CNS depressants: increases CNS depression

- Anticholinergics as they slow motility, secretions in the body: increases effects

- Antihypertensive medications: increases hypertension

- St. John's Wort: increases effects of morphine

morphine nursing interventions

- Monitor patient controlled analgesia machine (PCA) dosing and provide education to pt on how to use

- Only the pt can control PCA, not their famil

Morphine administered

- PO

- IM

- SQ

- IV

- rectally

- epidural

naloxone mechanism of action

- Interferes with the action of opioids by competing for opioid receptors.

- Has no effect in the absence of opioids

naloxone therapeutic use

- Treatment of opioid abuse by preventing euphoria

- Reversal of effects of opioids

- Drug of choice for managing acute opioid overdose

naloxone complications

- Tachycardia

- Abstinence Syndrome

naloxone abstinence syndrome

- cramping

- HTN (hypertension)

- vomiting

- reversal of analgesia

naloxone contraindications

- Clients with opioid dependency

- Assess prior to

administering

- Can still receive but

may send them into

withdrawal

naloxone other name

Narcan

Naloxone administration

- IM

- IV

- Inhalation

naloxone etc

- drug of choice for managing acute opioid overdose

- do not administer PO (pt at risk for vomiting)

- administer by titrating dosage

naloxone administer by titrating dosage

- slowly infuse the drug until desired effect

- do not infuse rapidly

- causes hypertension, tachycardia, nausea, vomiting

types of headaches

- migraine headaches

- cluster headaches

- tension headaches

migraine headaches

severe throbbing headaches, one side of the head

cluster headaches

- begins during sleep

- involve sharp steady eye pain

- sweating

- flushing

- tearing

- nasal congestion

tension headaches

usually occurs during stress, dull band of pain around entire head

take aspirin before taking

sumatriptans