19 analgesics, sedatives, hypnotics

  1. What do health care practitioners ask when assessing pain?
    Location and severity with validation of the pain assessment scale
  2. What are the components of pain?
    pyschological and physiological
  3. Why is pain threshold higher in some people?
    because of conditioning, ethnic background, sensitivity, or physiological factors (endorphin release)
  4. What is the purpose of endorphins?
    they block the transmission of pain
  5. endorphins are ______ analgesics produced within the body as a reaction to severe pain or intense exercise
  6. A term most commonly used to describe endorphins
    runner's high
  7. endorphin release may be responsible for a _____ effect
  8. relief from pain as the result of suggestion without the administration of an analgesic is an example of a _____
    placebo effect
  9. what can analgesics be classified as?
    opioid, nonopioid, and adjuvant
  10. _____ are classified as full or pure agonists, partial agonists, or mixed agonist antagonist depending on the specific receptors they bind to and their activity at the receptor
  11. ______ are commonly used because their action is similiar to that of opium in altering the perception of pain, and they do not have a ceiling to their analgesic effects
    full agonists
  12. this is referred to medication level at which there is no enhanced analgesia
    no ceiling
  13. what drug is considered a weak opiate agonist and is not currently classified as a controlled substance on the federal level?
  14. physical adaptation of the body that have withdrawal symptoms after abrupt drug discontinuation is:
  15. when a larger dose is needed to achieve the same analgesic effect
  16. is opioids used for extended periods?
    No. They are used mostly to relieve chronic pain
  17. how can opioids become a more effective pain medication?
    by combining nonopioids and adjuvants
  18. what does around the clock dosing do?
    prevent pain from developing
  19. drugs that enhance an analgesic effect are called:
    adjuvant analgesics

    (they can reduce the needed dosage of opioids)
  20. side effects of opioids
    • Blurred Vision
    • Urinary Retention
    • Respiratory depression
    • Nausea, vomiting, constipation

    • Flushing, rash, pruritus
    • Bradycardia
    • Confusion, euphoria, restlessness
    • Headache
    • Hypotension
    • SedationSexual dysfunction
  21. Opioid contraindications

    Abrupt discontinuation

    • COPD
    • Head Injury
    • Addiction prone, suicidal, alcoholic
    • Pregnancy, lactation

    • Driving or operating machinery
    • Opiate agonist hypersensitivty
    • GI, Hepatic, Renal, thyroid disease

    • Cardiac disease
    • Older adults
    • CNS depression
  22. Interactions of opioids with all CNS depressants

    • Alcohol
    • Antihist
    • Antiemetics
    • Antiarrythmics
    • Muscle relaxants
    • Psychotropcs
    • Sedatives/hypnotics
  23. An opioid that can be administered parenterally before the start of anesthesia
  24. patients with kidney disease should not use this because it may cause seizures
    meperidine (sounds like My poor kidney)
  25. these are used to manage moderate to severe pain due to their long duration of effect and potency
    morphine and hydromorphone (what i got at the docs)
  26. ____ is a centrally acting synthetic analog of codeine that has dual action, and produces analgesia by weak inhibition of norepinephrine and serotonin reuptake
    • tramadol
    • (think TRAMPS have a potential for abuse and resp. depression)
  27. Used in the treatment of opioid dependance
    • naltroxene (pure opioid antagonist)
    • buprenorphine (partial opioid antagonist)
  28. used in the treatment of opioid overdose in the OR, delivery room, and nursery for opiate induced respiratory depression
    Narcan (naloxone)

    (think narCAN help overdose)
  29. true or false

    Nonopioids are usually found OTC
  30. _______ are given for purposes of relieving mild to moderate pain, fever, and anti-inflammatory conditions
  31. nonopioids may also be used as a ______ in severe or acute or chronic pain requiring opioids
  32. _______ are most commonly used for their analgesic and antipyretic properties as well as anti inflammatory action
    Salicylates (asprin)
  33. _____ a nonopioid that has analgesic and antipyretic properties but very little effect on inflammation
  34. _____ & ______ actions are associated primarily with preventing the formation of prostaglandins and the subsequent inflammatory response prostaglandins help to reduce
    salicylate analgesic and antiinflammatory
  35. Side effects of salicylate and other NSAIDS
    • (PACT BRHD)
    • Poisoning
    • Anaphylaxis
    • Coma
    • Tinnitus (with overdose)

    • Bleeding/Bruising
    • Renal insufficeincy
    • Hepatic dysfunction
    • Drowsiness
  36. salicylate contraindication
    (BAG V CLAP)

    • Bleeding disorders
    • Asthma
    • GI disorders

    Vitamin K deficiency

    • Children younger than 15 bc of reyes syndrome
    • Lactation
    • Allergy to ASA
    • Pregnancy
  37. _____ should be discontinued 5-7 days before elective pre/postoperative surgery
  38. _____ is used extensively in the treatment of mild to moderate pain and fever and has little effect on inflammation
    acetaminophen (tylenol)
  39. Acetaminophen side effects
    • Severe liver toxicity
    • Renal insufficiency
    • Rash
    • Blood dyscrasias
  40. cautions with acetaminophen
    • alcohol
    • pregnancy/breastfeeding
  41. •Enhance analgesic effect with opioids and

    •Produce Analgesia alone, or reduce the side effects of analgesics
    adjuvant analgesics
  42. 2 classes of analgesia
    • –Anticonvulsants
    • –Antidepressants
  43. available topically in a patch and may be especially effective to treat nerve pain and other localized pain while avoiding adverse effects or oral or parenteral routes
    lidocaine (lidoderm)

    (dental nerve pain)
  44. a local anesthetic used for postherpatic neuralgia
  45. antidepressants used for fibromyalgia
    • Duloxetine (cymbalta)
    • Venlafaxine (effexor)
  46. •Treatment of nerve pain
    –“Burning pain”
    –Herpes, arthritis, cancer,
    migraine, diabetes, insomnia, and depression.

    •Increases available norepinephrine and
    serotonin – block pain transmission.
    Tricyclic Antidpressant
  47. ___ & _____ block pain transmission
    norepinephrine & serotonin
  48. Side effects r tricyclic antidepressants
    (DUST HOD )

    • Dry mouth
    • Urinary retention
    • Sedation
    • Tachyarrrythmias

    • Heart Block
    • Ortho Hypotention
    • Delirium
  49. Inhibit reuptake of both serotonin and norepinephrine
    Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
  50. SNRI antidepressants
    • Duloxetine (Cymbalta)
    • Venlafaxine (Effexor)
  51. used to treat diabetic neuropathy and fibromyalgia
    SNRI antidepressants
  52. SNRI antidepressant that has the potential to increase blood pressure and heart rate
    venlafaxne (effexor)
  53. SNRI side effects
    sleep disturbance, HA, nausea, stomach pain, diarrhea, constipation, sweating
  54. SNRI contraindications
    • (HANA)
    • hep/renal impairment
    • abrupt stop
    • narrow angle glaucoma
    • alcohol use
  55. SNRI Interactions with MAOI's and SSRIs
    • serotonin syndrome
    • (rapid development of hyperthermia, hypertension, coma, delirium, autonomic instability)
  56. anticonvulsant drugs used to manage nerve pain associated with neuralgia, shingles, and cancer
    • neurontin
    • tegratol

    (neuralgia= neurontin/ tegratol [TOL] = cancer TOLL)
  57. ______ therapy is used when patients describe the pain as sharp, shooting, shock like, or lightning like
  58. _______ is first line therapy for neuropathic pain followed by ________
    • Neurontin (gabapentin)
    • Tegratol (carbamazepine)
  59. A second generation anticonvulsant approved by the FDA for use in diabetic neuropathy and postherpatic neuralgia
    (lyrica) pregabalin (leuyurika)
Card Set
19 analgesics, sedatives, hypnotics
analgesics, sedatives, hypnotics