Pharm Analgesics

Pain Tolerance

Amount of pain a person can tolerate w/o it interfering with normal function. Varies by person and culture

Acute pain

Sudden onset, subsides when treated

Chronic pain

Persistent or recurring, Lasts more than 3 months, difficult to treat

Adjuvant drugs

Assist primary drugs in relieving pain (NSAIDS, antidepressants, Corticosteroids, anticonvulsants)

Opioid Drugs

Oxycodone, codeine, hydromorphone, MS Contin, Morphine, Fentanyl

Meperidine Contraindication

Not recc for long term bc accumulation of Neurotoxic metabolite that causes seizures

Opioid Ceiling Effect

Drug reaches max effect and Analgesia doesn’t incr w/ higher dose

Equianalgiesia

Doses and routes of diff meds that provide same amount of analgesia (7 mg Morphine = 1 mg Hydromorphone, 7x stonger than morphine)

Indication for Opioids

Alleviate Pain, cough center supression, diarrhea, balanced anesthesia

Contraindications for Opioids

Severe Asthma, obesity, sleep apnea (causes respiratory despression), glaucoma, paralytic ileus, pregnancy

Opioid Black Box Warning

Risk for misuses and abuse leading to addiction and death

Most serious side effect of Opiods

Respiratory Depression

Opioid interactions

Anything that’s a sedative

Adverse effects of fentanyl

Chest wall rigidity if pushed too fast

Opioid Agonist-Antagonists

Sched IV, Lower risk of misuse/addiction. Not strong enough for long term chronic pain

Naloxone (Narcan)

Pure opioid Antagonist

Uses for Naloxone

Partial or complete reversal of opioid induced respiratory depression

Indication for Acetaminophen

Mild to moderate pain and fever

Acetaminophen Dosage for healthy Adults

3000 mg/day MAX

Acetaminophen dosage for older adults (and adults w/liver dz)

2000 mg/day MAX

Acetaminophen is toxic to what organ

Liver

Reccomneded antidote for Acetaminophen

acetylcysteine regimen

Lidocaine, Transdermal (patch)

Topical anasthetic for local nerve pain

Lidocaine patch should be left in place for no longer than

12 hours

Always check for ______ When giving analgesics (Along w/ HR,BP,GI and O2)

Respirations

True or False

Always Medicate before pain becomes severe

True

Reassess ( ) to ( ) minutes after giving opioids

5-15 minutes