Medications for Pain & Inflammation part 3

aspirin like medications

- acetaminophen

- NSAIDS

serotonin receptor agonists (triptans)

sumatriptan

amide type

- lidocaine

- EMLA (topical cream)

sumatriptan therapeutic use

- used to stop migraines (abortive)

- usually taken in combination w NSAIDS to treat headaches

- vasoconstriction of cranial arteries

sumatriptan mechanism of action

Prevent inflammation and dilation of the intracranial blood vessels, thereby relieving migraine pain

sumatriptan complications

-chest pressure (heavy arms, chest tightness)

-Angina

- don't admin to pt with coronary artery disease CAD

-dizziness, vertigo

-Teratogenesis: avoid while pregnancy

- hypertension

sumatriptan contraindications/precautions

- liver failure

- ischemic heart disease

- hx or MI

- uncontrolled HTN

- other heart diseases

sumatriptan drug-drug interactions

- Concurrent use of MAOI can lead to toxicity

- Concurrent use with other migraine meds can cause vasospastic reaction

- SSRI's can cause serotonin syndrome (confusion, agitation, HTN, diaphoresis,

possible death)

sumatriptan education

- should not be used > 2 days/wk (overusing will cause migraines)

- avoid trigger or trigger foods

- lay down in a dark quiet place to ease symptoms

- take w food to dec GI upset

- antimetics

- pregancy risk c: encourage birth control

sumatriptan administration

- inhalation

- PO

- SQ

- transdermal

sumatriptan trigger foods

- tyramine foods

- alcohol

- meat

- cheese

- soy sauce

ester

- high incidence of allergic rxns

- short acting

amide

- immediate to long acting

lidocaine parenteral uses

- iv

- dental procedures

- minor surgeries

- labor + delivery

- regional anesthesia (spinal, epidural)

lidocaine topical uses

- drops

- skin + mucous membrane disorders

- control laryngeal + esophageal reflexes prior to endoscopic procedures

- minor procedures: iv insertion, wart removal

lidocaine mechanism of action

- decreases pain by blocking conduction of pain impulse

- no loss of consciousness occurs

lidocaine complications

- When medication is absorbed systemically = dysrhythmias

- CNS excitation = perioral numbness/tingling

- Visual auditory disturbances

- Seizures followed by respiratory depression

- Hypotension, cardiac suppression

- Prolonging of labor & delivery

- Urinary retention

- Lidocaine toxicity

lidocaine toxicity s/s

- metallic taste

- seizures

- CNS excitation

- drowsiness

lidocaine contraindications/precautions

- Supraventricular tachycardias, heart block

- Caution if pt has liver or kidney disease, heart failure, myasthenia gravis

- DO NOT administer medication in areas with ending arteries

- No fingers, toes, noes, and hose (penis)

If injecting in fingers, nose, or other parts of the body with end arteries =

use plain lidocaine as epinephrine is a vasoconstrictor & can lead to gangrene

lidocaine + epinephrine together =

- ↑ analgesic effects = controls bleeding

- delays systemic effe ts

Epinephrine contains

vasoconstricting properties that hold the medication in that area (localized) + helps control bleeding

if lidocaine administered epiduraly

monitor for seizures, hypotension, and dura punctures

post dural punctures

- causes headache (spinal headache)

- have pt lie flat for 12 hr post op