ATI PN Pharmacology for Nursing – Flashcards
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Medications for Pain and Inflammation
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Nonopioid Analgesics ››Opioid Agonists and Antagonists ›› Adjuvant Medications for Pain ››Miscellaneous Pain Medications
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Prototype Medication: acetaminophen (Tylenol) Expected Pharmacological Action ●● Therapeutic Uses
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◯◯ Acetaminophen slows the production of prostaglandins in the central nervous system. ◯◯ Analgesic (relief of pain) effect ◯◯ Antipyretic (reduction of fever) effects
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Adverse Effects of Acetaminophen ›› Adverse effects are rare at therapeutic dosages, but acute toxicity results in liver damage with early symptoms of nausea, vomiting, diarrhea, sweating, and abdominal discomfort progressing to hepatic failure, coma, and death
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Nursing Interventions/Client Education ›› Advise clients to take acetaminophen as prescribed and not to exceed 4 g/day. Parents should carefully follow provider's advice regarding administration of acetaminophen to children. ›› Administer the antidote, acetylcysteine (Mucomyst).
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Contraindications for acetaminophen
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●● Use cautiously in clients who consume three or more alcoholic drinks per day and those taking warfarin (interferes with metabolism), thus increasing the risk of bleeding.
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6. A nurse in an outpatient facility is providing teaching to a client who has osteoarthritis and is starting long-term therapy with naproxen sodium (Aleve) 500 mg twice daily. What should the nurse teach the client about this medication? Use the ATI Active Learning Template: Medication to complete this item to include the following: A. Therapeutic Use B. Adverse Effects: Describe two. C. Nursing Interventions: ●● Describe two laboratory values the nurse should monitor. ●● Describe two nursing actions.
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Using ATI Active Learning Template: Medication A. Therapeutic Use ●● Naproxen sodium is an NSAID. It will treat mild to moderate joint pain and stiffness, and decrease inflammation in the client who has osteoarthritis. B. Adverse Effects ●● Gastrointestinal effects may occur, including anorexia, abdominal pain, nausea/vomiting, and heartburn. ●● GI bleeding may occur because naproxen sodium affects platelet function. ●● Nephrotoxicity may occur. ●● Naproxen sodium and other NSAIDS may cause the CNS effects of dizziness, headache, blurred vision, and tinnitus. ●● Allergy may occur, including cross allergy with other NSAIDS, such as aspirin. C. Nursing Interventions ●● Diagnostic tests to monitor: Hgb/Hct and kidney function tests. Naproxen sodium is metabolized in the liver, so the nurse should also be prepared to monitor liver function. ●● Assess the client for previous allergy to NSAIDs. ●● Assess GI system, and ask about any history of GI bleed or peptic ulcer disease. ●● Advise the client to take the medication with food or prescribed antacid if GI distress occurs. ●● Advise the client to tell provider about any over-the-counter medications, vitamins, or herbals before taking them.
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Opioid Agonists and Antagonists
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●● Opioid analgesics are medications used to treat moderate to severe pain. Most opioid analgesics reduce pain by attaching to a receptor in the central nervous system, altering perception and response to pain. ●● Opioids are classified as agonists, agonist-antagonists, and antagonists. ●● An agonist attaches to a receptor and produces a response. ◯◯ An agonist-antagonist binds to one receptor, causing a response, and binds to another receptor, which prevents a response. ◯◯ An antagonist attaches to a receptor site and prevents a response. ●● The desired outcome is to reduce pain and increase activity with few adverse effects.
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Opioid Agonists - Prototype Medication: morphine
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●● Other Medications ◯◯ Fentanyl (Sublimaze, Duragesic) ◯◯ Meperidine (Demerol) ◯◯ Methadone (Dolophine) ◯◯ Codeine ◯◯ Oxycodone (OxyContin)
