Pain and Inflammation Med Charts

Name Mechanism of Action Therapeutic Uses Side Effects/ Precautions Interactions Nursing/Pati ent teaching Common Drugs Name Mechanism of Action Therapeutic Uses Side Effects/ Precautions Interactions Nursing/Pati ent teaching Common Drugs Name Mechanism of Action Therapeutic Uses Side Effects/ Precautions Nonsteroidal Antinflammatory Drugs inhibition of cyclooxygenase, results in decrease in platelet aggregation, inflammation, fever, pain inflammation, mild analgesia, fever, dysmenorrhea, inhibition of platelet aggregation (protection against stroke, MI) GI upset, damage to gastric mucosa, renal dysfunction, increased risk of MI and stroke(for non ASA NSAIDS), Salicylism risk for ASA(tinnitus, sweating, HA, respiratory aklaosis) increased risk of bleeding with other anticoagulants, glucocorticoids, alcohol. Ibuprofen decreases antiplatelet effects of ASA take NSAIDS with food to decrease gastric discomfort, notify provider if symptoms of salicylism occurs, concurrent use with opioids allow for lower dosages of opioids ASA, Ibuprofen, Naproxen, Indomethacin (Indocin), Ketorolac (Toradol), Meloxicam (Mobic), Colecoxib (Celebrex) Acetaminophen slows production of protaglandins in CNS analgesic, antipyretic acute toxicity results in liver damage (early symptoms include nausea, vomiting, diarrhea, sweating, abdominal discomfort) alcohol increases risk of liver damage, slows metabolism of warfarin do not exceed 4 mg/ day, acetylcysteine (Mucomyst) is antidote for overdose tylenol

Opioid Agonist act on mu and kappa receptors, produces analgesia, respiratory depression, euphoria, sedation, decreased GI motility moderate to severe pain respiratory depression, constipation, orthostatic hypotension, urinary retention, cough suppression, sedation, emesis

Interactions

CNS depressants have additive depression action. Anticholinergics, antihistamines, tricyclic antidepressants have additive anticholinergic effects. MAOIs may cause hyperpyrexic coma. overdose triad: coma, repiratory depression, pinpoint pupils. Administer very slowly, over 4 to 5 minutes. Narcan is antidote. Do not administer more than 600 mg/24 hour period for meperidine (Demerol). morphine, Fentanyl (Sublimaze, Duragesic), Meperidine (Demoerol), Methadone (Dolophine), Codeine/oxycodone (OxyContin) Agonist - antagonist opioids antagonists act on mu and kappa receptors, lower potential for abuse, less respiratory depression, and less analgesic effect compared to pure opioid agonists moderate to sever pain, treament of opioid dependence, adjunct to balanced anesthesia,, sedation, respiratory depression, dizziness, increased intracranial pressure, HA, increased cardiac workload. abstinence syndrome (for those who are dependant on opioids) additive CNS depression with other CNS depressants, opioid agonists may antagonize and reduce analgesic effects (do not use concurrently) caution when undisclosed opioid use is suspected. Again, opioid agonist and opioid agonist antagonist should not be used together. Naloxone (narcan) is antidote butorphanol (Stadol), hydrochloride (Nubain), Buprenorphine hydrochloride (Buprenex) Adjuvant Medications for Pain: used with a primary pain medication, usually an opioid agonist in order to reduce opioid dosage to reduce side effects.

Nursing/Pati ent teaching Common Drugs Name Mechanism of Action Therapeutic Uses Side Effects/ Precautions Interactions Nursing/Pati ent teaching Common Drugs

NSAIDS Tricyclic antidepress ants Anticonvulsa nts CNS stimulants Antihistamin es

treats inflammation. side effects: bone marrow suppresion, GI distress treats depression, neuropathic pain such as cramping/aching/burning. (amitriptyline (Elavil)) side effects: orthostatic hypotension, sedation, anticholinergic effects neuropathic pain (carbamazepine (Tegretol), gabapentin (Neurontin)) side effects: bone marrow suprresion, GI distress analgesia, decrease sedation. (methylphenidate (Ritalin)) side effects: weight loss, insomnia decrease anxiety, prevent insomnia and relieve nausea (hydroxyzine (Vistaril))

Bisphosphon ates glucocorticoi ds

manage hypercalcemia and bone pain (etidronate (Didronel)) side effects: flu like symptoms, venous irritation, renal failure decrease pain from intracranial pressure and spinal cord compression. (dexamethason (Didronel)) side effects: adrenal insufficiency, osteoporosis, hypokalemia, glucose intolerance, peptic ulcer disease

Name Mechanism of Action Therapeutic Uses Side Effects/ Precautions Interactions Nursing/Pati ent teaching Common Drugs

Migraine Meds prevent inflammation and dilation of the intracranial blood vessels, relieving migraine pain stopping acute migraine attacks, prevention of chronic migrains depends on type (pg 473) depends on type avoid trigger factors that cause stress (alcohol, fatigue, tyramine containing foods (aged cheese)) Ergot alkaloids: ergotamine (Ergostat) Serotonin receptor agonist: sumatriptan (Imitrex) Beta Blockers: propranolol (Inderal) Anticonvulsants: divalproex (Depakote) Tricyclic antidepressants: anitriptyline (Elavil) Calcium channel blockers: verapamil (Calan) Estrogens: Estraderm Ergot alkaloids: Cafergot

Name Mechanism of Action Therapeutic Uses Side Effects/ Precautions Interactions Nursing/ Patient

Local Anesthetics decrease pain by blocking conduction of pain impulses in a specific area dental procedures, minor surgical procedures, labor and delivery, regional anesthesia, skin and mucous membrane disorders, minor procedures (IV insertion, injection, wart removal) CNS excitation (seizures, followed by respiratory depression, leading to unconsciousness), hypotension, can prolong labor additive hypotensive effects with parenteral administration vasoconstrictors (epinephrine) often used in combination with local anesthetic to stop the spread. topical cream applied one hour before

teaching Common Drugs

procedure. lidocaine (Xylocaine), tetracain (Pontocaine), procain (Novocain)