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ACETAMINOPHEN
(a-seat-a-mee-noe-fen)
(Tylenol)
Nonopiod Analgesics
- SIDE EFFECTS:
- Anemia (long-term use) Liver and kidney failure (high prolonged doses)
- NURSING CONSIDERATIONS:
- Treatment of mild pain or fever
- PO: onset less than 1 hour, peak 1/2-2 hours, duration 4-6 hours
- Rectal: onset slow, peak 1-2 hours, duration 3-4 hours.
- Take crushed or whole with full glass of water.
- Can give with food or milk to decrease GI upset. S
- Signs of chronic poisoning: rapid, weak pulse, dyspnea, cold, clammy extremities.
- Signs of chronic overdose: bleeding, bruising, malaise, fever, sore throat.
OTC: Preg Cat B
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ASPIRIN
(as-pir-in)
Nonopioid analgesic
- SIDE EFFECTS:
- Nausea, vomiting, rash
- NURSING CONSIDERATIONS:
- Management of mild to moderate pain or fever, transient ischemic attacks, prophylaxis of MI, ischemic stroke, angina.
- PO: Onset 15-30 minutes peak 1-2 hours, duration 4-6 hours
- Rectal: Onset slow, 20-60% absorbed if retained 2-4 hours
- With long-term use check for liver damage: dark urine, clay colored stools, yellowing of skin and sclera, itching, abd pain, fever, diarrhea.
- For arthritis give 30 minutes before exercise.
- May take 2 weeks before full effect is felt
- discard tablets if vinegar like smell
- Do not give to children or teens with flulike symptoms or chicken pox, reye's symptom may develop
OTC: Preg Cat C
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CELECOXIB
(sel-eh-cox-ib)
(celebrex)
Nonopioid analgesics
- SIDE EFFECTS:
- Recent research shows increased risk of heart attack or stroke. Serious skin reactions and intestinal problems (bleeding ulcers) can occur without warning. Fatigue, anxiety, depression, nervousness, nausea, vomiting, anorexia, dry mout, constipation.
- NURSING CONSIDERATIONS:
- Also in category of nonsteroidal anti-inflammattories
- Management of acute, chronic arthritis pain and primary dysmenorrhea pain relief. Can take without regard to meals. Increasing doses does not increase effectiveness.
- Do not talke if allergic to sulfonamides, aspirin, or NSAIDs, caution with any Hx of drug allergies.
- RX: Preg Cat C for first and second trimester: Preg Cat C for third trimester.
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IBUPROFEN
(eye-byoo-proe-fen)
(Motrin, Advil)
Nonopioid analgesics
- SIDE EFFECTS:
- Headache, nausea, anorexia, GI bleeding, Blood dyscrasias
- NURSING CONSIDERATIONS:
- Treatment of rheumatiod arthritis, osteoarthritis, primary dysmenorrhea, gout, dental pain, musculoskeletal disorders, fever.
- Onset:1/2 hour, peak 1-2 hours
- contact clinician if ringing or roaring in ears, which may indicate toxicity.
- Contact clinician if changes in urinary pattern, increased weight, edema, increased pain in joints, fever, blood in urine, which may indicate kidney damage.
- Use sunscreen to prevent photosensitivity
- Avoid use with ASA NSAIDs, and alcohol, which may precipitate GI bleeding
- OTC/RX: Preg Cat B
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CODEINE
(koe-deen)
Opiod Analgesics
- SIDE EFFECTS:
- Drowsiness, sedation nausea, vomiting, anorexia, respiratory depression, constipation orthostatic hypotension
- NURSING CONSIDERATIONS: Treatment of moderate to severe pain, nonproductive cough
- PO: Onset 30-45 min peak 60-120 min, duration 5-6 hours.
- IM/SubQ: Onset 10-40 minutes duration 4-6 hours do not give if respirations are less than 12 per minute.
- Avoid use with alcohol, other CNS depressants withdrawl symptoms may occur: nausea, vomiting, cramps, fever, faintness, anorexia.
- Physical dependency may result from long-term use.
- RX: Schedule C-II, III, IV, V (depends on route) Preg Cat C
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HYDROCODONE BITARTRATE & ACETAMINOPHEN
(hi-dro-ko-doan)
(Lortaabs)
Opoid Analgesic
- SIDE EFFECTS:
- Dizziness, drowsiness, constipation, nausea, vomiting.
- NURSING CONSIDERATIONS: Used for relief of moderate to moderately severe pain. Use with CNS depressants and/or alcohol may result in additive CNS depression. May be habit-forming
- Avoid alcohol during treatment
- Use with caution in patients with pulmonary considerations.
- RX: Schedule C-III Preg Cat C
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HYDROMORPHONE
(hye-droe-mor-foan)
(Dilaudid)
Opoid Analgesic
- SIDE EFFECTS:
- Drowsiness, sedation, nausea, vomiting, anorexia, respiratory depresssion, constipation, cramps, orthostatic hypotension, confusion, headache, rash.
- NURSING CONSIDERATIONS:
- Treatment of moderate to severe pain, nonproductive cough
- PO: onset 15-30 minutes, peak 30-60 minutes, duration 4-6 hours
- IM: onset 15 minutes, peak 30-60 minutes, duration 4-5 hours.
- IV: onset 10-15 minutes, peak 15-30 minutes, duration 2-3 hours.
- SubQ: onset 15 minutes, peak 30-90 minutes, duration 4 hours.
- Rectal: duration 6-8 hours
- Do not give if respirations are less than 12 per minute
- Avoid use with alcohol. other CNS depressants
- Withdrawal symptoms may occur: nausea, vomiting, cramps, fever, faintness, anorexia.
- Physical dependency may result from long-term use
- RX; Schedule C-II Preg Cat C
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MEPERIDINE
(me-per-i-deen)
(Demerol)
Opoid analgesic
- SIDE EFFECTS:
- Drowsiness, sedation, respiratory depression, euphoria, orthostatic hypotension, confusion, headache.
- NURSING CONSIDERATIONS:
- Management of moderate to severe pain, pre=op sedation, post-op and OB analgesia
- PO: onset 10-15 minutes, peak 30-60 minutes, duration 2-4 hours (usually 3)
- IM: onset 10-15 minutes, peak 30-50 minutes, duration 2-4 hours (usually 3)
- IV: onset less than 5 minutes, peak 5-7 minutes, duration 2-4 hours (usually 3)
- SubQ: onset 10-15 minutes, peak 30-50 minutes duration 2-4 hours (usually3)
- Do not give if respirations are less than 12 per minute. Aboid with alcohol, other CNS depressants. Withdrawal symptoms may occur: nausea, vomiting, cramps, fever, faintness, anorexia
- Physical dependency may result from long-term use
- RX: Schedule C-II Preg Cat C
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METHADONE
(meth-a-doan)
Opiod Analgesic
- SIDE EFFECTS:
- Drowsiness, sedation, nausea, vomiting, anorexia, respiratory depression, constipation, cramps, orthostatic hypotension, confusion, headache, rash
- NURSING CONSIDERATIONS:
- Relief of pain, detoxification/maintenance of narcotic addiction
- PO:onset 30-60 minutes, peak 30-60 minutes, duration 4-6 hours (with continuous dosing, duration of action may increase to 22 to 48 hours)
- IM: onset 10-20 minutes, peak 60-120 minutes, duration 4-5 hours (with continuous dosing, duration of action may increase to 22 to 48 hours)
- IV: onset peak 15-30 minutes, duration 3-4 hours.
- Do not give if respirations are less than 12 per minute. Avoid use with alcohol, other CNS depressants.
- Withdrawal may occur: nausea, vomiting, cramps, fever, faintness, anorexia.
- Physical dependency may result from long term use
- RX: Schedule C-II Preg Cat C
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MORPHINE
(Mor-feen)
(MS Contin)
Opiod Analgesic
- SIDE EFFECTS:
- Respiratory depression, Sedation, Euphoria, Orthostatic hypotension
- NURSING CONSIDERATIONS:
- Management of severe pain. Continuous dosing is more effective than prn: may be given by patient controlled analgesia (PCA)
- PO: onset 15-60 minutes, peak 30-60 minutes, duration 3-6 hours
- IM: onset 10-15 minutes, peak 30-50 minutes, duation 2-4 hours (usually 3)
- IV: onset less than 5 minutes, peak 18 minutes, duration 3-6 hours
- SubQ: onset 10-15 minutes, peak 30-50 minutes, duration 2-4 hours (usually 3)
- Withdrawal symptoms may occur: nausea, vomiting, cramps, fever, faintness, anorexia.
- Physical dependency may result from long term use
- RX: Schedule C-II Preg Cat C
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OXYCODONE
(ox-i-koe-doan)
(Oxy Contin, with aspirin, Percodan, with acetaminophen: percoset)
- SIDE EFFECTS:
- Drowsiness, sedation, nausea, vomiting, anorexia, respiratory depression, constipation, cramps, orthostatic hypotension, confusion, headache, rash, euphoria.
- NURSING CONSIDERATIONS:
- Management of moderate to severe pain
- PO: peak 30-60 minutes, duration 4-6 hours, controlled realease: peak 3-4 minutes, duration 12 hours.
- Do not give if respirations are less than 12 per minute. Avoid use with alcohol other CNS depressants.
- Withdrawal symptoms may occur: nausea, vomiting, cramps, fever, faintness, anorexia
- Physical dependency may result from long term use
- RX: Schedule C-II Preg Cat B
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PROPOXYPHENE
(proe-pox-i-feen)
Darvon, Darvocet-N, (propoxyphene with acetominophen))
- SIDE EFFECTS:
- Drowsiness, sedation, nausea, vomiting, anorexia, respiratory depression, constipation, cramps, orthostatic hypotension, confusion, headache, rash
- NURSING CONSIDERATIONS: Management of mild to moderate pain.
- PO: onset 30-60 minutes, peak 120 minutes, duration 4-6 hours.
- Low schedule rating for misuse potential, addiction liability.
- Do not use in patients with suicidal tendencies.
- Avoid use with alcohol, other CNS depressants.
- Withdrawal symptoms may occur: nausea, vomiting, cramps, fever, faintness, anorexia.
- Physical dependency may result from long term use with high doses.
- RX: Schedule C- IV Preg Cat C
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TRAMADOL
(trah-mah-dole)
(Ultram, Ultram ER, Ultracet (tramadol with acetominophen))
- SIDE EFFECTS:
- Dizziness, drowsiness, sedation, insomnia, nervousness, agitation, uncontrollable shaking, muscle tightness, changes in mood.
- NURSING CONSIDERATIONS:
- Management of moderate to moderately severe pain.
- Notify prescribe of significant symptoms: seizures, sores in mout, nose or throat; flu like symptoms; hives; rash; difficulty swallowing or breathing; hallucinations.
- Sudden discontinuation may cause withdrawal symptoms: nervousness, panic sweating, insomnia
- RX: Not a controlled substance Preg Cat C
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