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NR293 Pharm Exam 2 Chamberlain Questions and answers + rationales what are analgesics? ; medications that relieve pain : without loss of consciousness What is nociception? ! perception of pain what is a pain threshold? | stimuli needed to produce the ! sensation of pain what is a pain tolerance? different for everyone, amount of { pain a person can endure without : interfering with normal ! functioning somatic pain ; originates from skeletal muscle, : ligaments, and joints referred pain pain that is felt in a location other : than where the pain originates visceral pain : originates from organs and ! smooth muscle central pain marked by chronic pain stemming : from damage to CNS bradykinin ' causes vasodilation What are adjuvant drugs? assist primary drugs in relieving ! pain what are opioid drugs? t synthetic drugs that bind to the ! opiate receptors to relieve pain mild agonist opioid drugs : codeine and hydrocodone strong agonists morphine, hydromorphone, { oxycodone, meperidine, fentanyl, : and methadone Can a nurse dilute opioid drugs in an iv? No, not unless the pharmacy ! specifically says to and opioids ; should not be given through a : normal saline device what is the opioid ceiling effect? ; drug reaches a maximum } analgesic effect If you take 5 mg of a medication for pain, that 5 mg will go to will happen? . Even if you increase the dose, it ; will have the same effect no ! matter how much you take, can . . : have more of an adverse effect receptor sites to block pain signals } ; ! (why the pt may take more and but let's say you take 10 mg, What : . * more of something and then take { more and then they begin to ! overdose. APulse B.Blood pressure C.Temperature D. Respirations opioid analgesics adverse effects : CNS depression, Gl upset, urinary ‘ retention (check bladder ! distention), diaphoresis/flushing, pupil constriction, constipation, ‘itching what is a common opioid medication given for overdose? Naloxone (Narcan) what do opioid analgesics interact with? : alcohol, antihistamines, ! barbiturates, benzos codeine sulfate | less effective, more commonly i used as an antitussive fentanyl narrow therapeutic window; injection, patch, lozenges Methadone Hydrochloride (Dolophine) synthetic opioid analgesic, choice : for detoxification for opioid addicts, prolonged QT interval and : causes cardiac dysrhythmias morphine sulfate opioid analgesic, prototype; used ! for severe pain Naxolone (Narcan) opioid antagonist; for complete or : partial reversal of opioid induced ! respiratory depression Acetaminophen (tylenol) non-opioid analgesic; can alter | liver function, antipyretic and i analgesic effects Acetaminophen MOA blocks pain impulses peripherally | by inhibiting prostaglandin { synthesis Acetaminophen indications mild to moderate pain (3-5), fever, { alternative to aspirin Acetaminophen max dosage ; <3000 mg/day ! <2000 mg/day for older adults . wp gs drug allergy, liver dysfunction, Acetaminophen Contraindications : 9 . gy ¥ ; liver failure A patient with a history of heavy alcohol use needs a medication for pain. The recommended maximum daily dose of acetaminophen for this patient would be A.1000 mg. B.2000 mg. C.3000 mg. 4000 mg. ! B. 2000 mg what are the intermediate acting benzodiazepines? Alprazolam (Xanax), lorazepam (Ativa) when is clonazepam used? for alcohol withdrawal or extreme anxiety when is xanax used? reduce anxiety when is ativan used? clinical setting, sleep when is Versed used? clinical setting, outpatient procedures, puts patient to sleep for 20-30 minutes Benzodiazepines MOA depresses CNS activity Benzodiazepines: Drug Effects calming on CNS, not a direct muscle relaxant Benzodiazepines: Indications sedation, skeletal muscle relaxation, anxiety relief, acute seizure disorders, agitation Benzodiazepines adverse effects headache, drowsiness, dizziness, "hangover effect or daytime sleepiness When providing education to the patient on the use of a benzodiazepine medication, the nurse will include which information? A.These medications have little effect on the normal sleep cycle. B B.Using this medication may cause drowsiness the next day. C.lt is safe to drive while taking this medication. D.These drugs are safe to use with alcohol. which is more common with Benzodiazepines- overdose or respiratory depression? overdose what is the antidote for Ativan ? Flumazenil (Romazicon) Benzodiazepines interactions can heighten effects of other suppressants , grapefruit juice, : other CNS depressants when is diazepam (valium) used? ! anxiety or alcohol withdrawal When is Eszopiclone (Lunesta) used? hypnotic effect, keeps you asleep, ! provide full 8 hour : short acting hypnotic, low incidence of daytime sleepiness when is Zolpidem (Ambien) used? : but can sleepwalk : not given to older adults Kava should not be taken with which Benzodiazepines? Ambien, Lunesta, and Sonata Barbiturates MOA Increase the DURATION of GABA- { mediated chloride ion channels barbiturates drug interactions alcohol, benzodiazepines Pentobarbital (Nembutal) long acting, clinical use, prevent tonic-clonic seizures Barbiturates have a low therapeutic index. This means A.low doses are not therapeutic. B.the toxic range is narrow. C.they are habit forming. the effective, safe dosage range is narrow. common barbiturates Phenobarbital and Pentobarbital what are the 2 types of muscle relaxants? direct and indirect indications of muscle relaxants painful musculoskeletal conditions, back spasms, cerebral palsy muscle relaxants adverse effects dizziness, drowsiness, fatigue, common muscle relaxants Cyclobenzaprine (Flexaril) and Dantrolene (Dantrium) Which statement regarding muscle relaxants does the nurse identify as being accurate? A.Baclofen (Lioresal) is available as an injectable form for use with an implantable pump device. A B.Cyclobenzaprine (Flexeril) produces little sedation. C.Patients taking muscle relaxants are at high risk of developing hypertension. D.Patients taking muscle relaxants should be told to stop taking the medication if they feel sleepy. what are CNS stimulants? drugs that stimulate a specific ! area of the brain or spinal cord CNS stimulant MOA stimulate areas of the brain : associated with mental alertness what conditions are CNS stimulants used for? : ADHD, Narcolepsy, migraines, ; neonatal apnea what are the drug effects of CNS suppressants? ! relaxation of bronchial smooth { muscle, increased respiration, } dilation of pulmonary arteries adverse effects of CNS suppressants ! tachycardia, palpitations, angina, { anxiety, urinary frequency, nausea, ‘ vomiting, dry mouth, insomnia What is an amphetamine used to treat? ; ADHD and narcolepsy -go to is + amphetamine aspartate (Adderall) What is atomexetine? What is it used for? ; Itis an amphetamine CNS ! depressant used to treat Adderall -has a black box warning for { suicidal thoughts A.hypertension. B.allergy to penicillin. C.chronic bronchitis. D.cataracts. Triptans MOA cause vasoconstriction in cerebral arteries Triptans adverse effects vasoconstriction, irritation at injection site, tingling, flushing What is Sumatriptan (Imitrex)? It is a antimigraine medication used for headaches. what are analeptics? used for neonatal apnea ; caffeine; used for bronchodilation Analeptics-Caffeine (what does it do) increases HR and can cause palpitations what are adverse effects of Analeptics? muscle tension and tremors nursing implications for analeptics assess for euphoria what is a seizure brief episode of abnormal electrical activity in nerve cells of the brain what is a convulsion involuntary spasms of voluntary muscles-skeletal, facial, and ocular what is epilepsy? chronic, recurrent pattern of seizures what does idiopathic mean? no know cause underlying cause (ex-trauma, . . > what is secondary epilepsy? infection) 
