active recall part IV
Opioids (Morphine & Codeine)
Q: What are the prototype opioid drugs?
A: Morphine and Codeine.
Q: What is the primary indication for opioids?
A: Moderate to severe pain.
Q: What is the most dangerous adverse effect of opioids?
A: Respiratory depression.
Q: What CNS adverse effects occur with opioids?
A: Sedation, drowsiness, dizziness.
Q: What GI adverse effect occurs with opioids?
A: Constipation.
Q: What cardiovascular effect may opioids cause?
A: Hypotension.
Q: What should the nurse assess before giving an opioid?
A: Pain level, respiratory rate, level of consciousness.
Q: What respiratory rate would make you question administering an opioid?
A: Usually less than 12 breaths/min.
Q: What patient teaching is important for opioids?
A: Avoid alcohol and other CNS depressants, do not drive until effects are known, increase fluids/fiber for constipation.
Opioid Agonist-Antagonist
Q: What is the prototype opioid agonist-antagonist?
A: Pentazocine.
Q: Why should pentazocine be used cautiously in opioid-dependent patients?
A: It may precipitate withdrawal.
Pain Concepts
Q: What are the three major components of pain discussed in the objectives?
A: Pain perception, pain type, pain interpretation.
Q: What is the nurse's most reliable indicator of pain?
A: The patient's report.
Aspirin (Salicylate)
Q: What is the prototype salicylate?
A: Aspirin.
Q: What are common indications for aspirin?
A: Pain, fever, inflammation, antiplatelet therapy.
Q: What serious GI adverse effect is associated with aspirin?
A: GI bleeding.
Q: What is salicylism?
A: Aspirin toxicity characterized by tinnitus (ringing in ears).
Q: Why should aspirin be avoided in children with viral illnesses?
A: Risk of Reye syndrome.
Q: What should the nurse monitor in patients taking aspirin?
A: Bleeding, bruising, GI upset.
NSAIDs
Q: What is the prototype nonspecific COX inhibitor?
A: Ibuprofen.
Q: What enzyme do NSAIDs inhibit?
A: Cyclooxygenase (COX).
Q: What does inhibiting COX decrease?
A: Prostaglandin production.
Q: What are the major therapeutic effects of NSAIDs?
A: Pain relief, anti-inflammatory effects, antipyretic effects.
Q: What major adverse effect do NSAIDs share with aspirin?
A: GI irritation and GI bleeding.
Q: What organ system should be monitored with long-term NSAID use?
A: Kidneys.
Celecoxib
Q: What type of NSAID is celecoxib?
A: COX-2 selective inhibitor.
Q: Why was celecoxib developed?
A: To reduce GI adverse effects associated with COX-1 inhibition.
Q: Does celecoxib completely eliminate GI risk?
A: No.
Acetaminophen
Q: What is the prototype para-aminophenol derivative?
A: Acetaminophen.
Q: What are the primary uses of acetaminophen?
A: Pain relief and fever reduction.
Q: Does acetaminophen have significant anti-inflammatory effects?
A: No.
Q: What is the major toxicity associated with acetaminophen?
A: Liver toxicity.
Q: What patient teaching is important for acetaminophen?
A: Avoid exceeding the maximum daily dose and check combination products for hidden acetaminophen.
Nursing Implications
Q: What is the nurse's role in pain management?
A: Assess pain, administer medications safely, evaluate response, educate patient.
Q: What is the most important way to evaluate pain medication effectiveness?
A: Reassess the patient's pain after administration.
Q: Why is reassessment important?
A: To determine whether the medication achieved the desired therapeutic effect.
The 10 Things I'd Memorize Before Bed
Morphine = prototype opioid
Codeine = opioid
Pentazocine = opioid agonist-antagonist
Aspirin = salicylate
Ibuprofen = nonspecific COX inhibitor
Celecoxib = COX-2 selective inhibitor
Acetaminophen = liver toxicity
Aspirin = GI bleeding + tinnitus + Reye syndrome
Opioids = respiratory depression + constipation
Pain reassessment is how you evaluate effectiveness
If you can answer these active recall questions without looking, you'll have covered a huge portion of Part IV's testable material. 💊🔥