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name some opioids
codeine, morphine, methadone, fentanyl, hydrocodone, oxycodone, tramadol, hydromorphone, meperidine
therapeutic class of opioids
analgesic
method of action of opioids
binds to pain receptors in brain
opioids are used for:
moderate to severe pain
opioid contraindications
allergy, head injury, obesity, sleep apnea, respiratory insufficiency
drug interactions for opioids
CNS depressants
nursing implications for opioids
vitals, allergy, respiratory, gi, neuro, pain assessment(pqrst)
adverse effects of opioids
CNS depression, hypotension, respiratory depression, GI upset, itching, UTI, abuse potential
what drug class is ibuprofen
NSAID
what drug class is indomethacin
NSAID
what drug class is naproxen
NSAID
what drug class is ketorolac
NSAID
what drug class is meloxicam
NSAID
what therapeutic classes for NSAIDs
antipyretic, antinflammatory, analgesic
method of action for NSAIDs
inhibits prostaglandins which moderate pain
indications for NSAIDs
mild-moderate pain, arthritis, acute gout used with opioids for chronic pain relief
contraindications for NSAIDs
PUD, renal or hepatic problems, anticoags, bleeding problems, GI problems
nursing implications for NSAIDs
renal hepatic labs, hemoglobin, platelets, allergy
what are the renal/hepatic labs
BUN, AST, ALT, creatinine
adverse affects of NSAIDs
cardiovascular/ cerebrovascular event, GI upset, renal/liver failure, excessive bleeding
what are the drug(s) for salicylates?
acetylsalicylic acid
therapeutic classes for salicylates
antipyretic, analgesic, anti-inflammatory
method of action for salicylates
inhibits prostaglandin synthesis
indications for salicylates
mild-moderate pain with inflammatory conditions, TIA, CVA, MI prevention, fever
contraindications for salicylates
PUD, bleeding, renal/liver problems, children with flu symptoms
children with flu symptoms should NOT be put on what medicine class?
salicylates
what can salicylates cause in children with flu symptoms?
Reyes disease
nursing implications for salicylates
vitals, labs (platelet, hemoglobin, BUN, AST, ALT, creatinine), CBC and LFT labs
salicylate adverse effects
excessive bleeding, tinnitus, GI upset, hepatic/renal failure, salicylate poisoning
what drug(s) are para-aminophenol derivatives?
acetominophen
therapeutic class(es) of para-aminophenol derivatives
antipyretic, analgesic
method of action for para-aminophenol derivatives
inhibits prostaglandin synthesis
indications for para-aminophenol derivatives
fever, mild-moderate pain
contraindications for para-aminophenol derivatives
liver/kidney issues, anemia
drug interactions with para-aminophenol derivatives
other products with acetaminophen
nursing implications for para-aminophenol derivatives
monitor liver/kidney labs, watch for toxicity, blood labs for anemia, itching, rash
what drug is given for para-aminophenol derivative overdoes?
acetylcystine
adverse effects for para-aminophenol derivatives
toxicity, renal/hepatic failure, rash, itching, GI upset, anemia
what drug class is allopurinol?
antigout
what drug class is colchicine?
antigout
what drug class is probenecid?
antigout
what drug class is febuxostat?
antigout
what do antigout drugs address pathophysiologically?
overproduction or underexcretion of uric acid
antigout indications
patient with gout who doesn't respond to NSAIDs
contraindications of antigout meds
severe renal, cardiac, hepatic, GI dysfunction
nursing implications for antigout
always try NSAIDs first, pain assessment, GI assessment, labs, hydration, no alcohol or caffeine
what labs do you check for antigout?
CBC, uric acid, renal and hepatic
adverse affects for antigout drugs
GI distress, kidney stones, leukopenia