Herzing university HESI Pharmacology
Review -Analgesics & Anesthetics
Guidelines (Exam-Focused Study Guide)
, HESI PHARMACOLOGY BLUEPRINT
ANALGESICS AND SENSORY MEDICATIONS
❖ 2 types, non-opioids (non-sedating) and opioids (sedating, think low and slow)
❖ Non-opioids
➢ NSAIDs & Acetaminophen (Tylenol)
▪ Anti-pyretic (anti-fever)
▪ Anti-inflammatory (NSAIDS only)
▪ NOT a CNS depressant
▪ Vital signs will not be affected or “low and slow”
❖ SUFFIXES
➢ Opioids -done/-one
➢ NSAIDs (anti-inflammatory) -olac/-profen
➢ Salicylate -ASA
➢ Nonsalicylate -Acetaminophen
❖ NSAID examples:
➢ Remember NSAIK
▪ Naproxen - #1 NSAID given
▪ Salicylate acid (Aspirin)
▪ Acetylsalicylic acid (Aspirin)
▪ Ibuprofen & Indomethacin
▪ Ketorolac (brand: Toradol) only NSAID that can be given through IV
❖ Common HESI questions about analgesics
➢ Gout teaching is effective when your patient states what?
▪ “I can use Ibuprofen or Naproxen for pain relief”
➢ Patient with rheumatoid arthritis says they can use what for pain relief.
▪ “I can use NSAIDs to relieve the symptoms of my pain”
❖ Mechanism of action for NSAIDs
➢ NSAIDs decrease prostaglandin in response.
, ▪ To decrease pain and inflammation, think that Prostaglandins are like a big party
popper that basically puffs up the body and contributes to inflammation
▪ Decrease platelet aggregation, especially with aspirin which leads to a big risk for
bleeds
❖ NSAIDs are not good for the entire body
➢ GI. Bleeding – BAD for ulcers
➢ LUNGS – BAD for asthma
➢ Heart – HTN & Heart Failure
➢ Kidney clogging – increased Creat & BUN
➢ BLOOD clots
▪ KEY POINT
• NEVER TAKE 2 NSAIDS simultaneously
• Use the lowest dose for the shortest amount of time possible
❖ STICKY BLOOD CLOTS – Increased risk for thrombosis
➢ BAD for patients with CLOT HISTORY, MI, STROKE, DVT, PE
❖ ASTHMA WORSENING
➢ NSAIDs are NOT SAFE for ASTHMA and will make it worse
▪ HESI question
• Patients with asthma or nasal polyps
◆ “Use acetaminophen instead of NSAID”
❖ INCREASED BLEED RISK!
➢ NOTIFY HCP Bleeding
▪ Easy bruising
▪ Tarry stool and coffee-ground emesis = GI bleed
➢ AVOID – Peptic Ulcer patients, leading to GI bleeding
➢ Always take with food, never on an empty stomach
➢ If the patient is on an PPI, it is ok to use an NSAID
❖ BIG KEY POINT AVOID EGGO vitamins
➢ E – Vitamin E
, ➢ G – Gingko, Garlic
➢ O – Omega 3 oils
▪ mixed with those vitamins, it can cause an increased risk for bleeding
➢ HESI QUESTIONS
▪ Ibuprofen
• Do NOT take on an empty stomach
• Patient with Acid reflux on Ranitidine (PPI) & NSAID is ok
• It is ok to occasionally take ibuprofen for knee pain for a rheumatoid arthritis
patient
❖ DYSFUNCTIONAL KIDNEYS – Renal Injury = Long Term Use
➢ Memory Tricks
▪ Creatinine over 1.3 = BAD KIDNEY!
▪ Urine output 30 mL/hr or LESS = KIDNEYS in Distress!
▪ Ketorolac – KILLS the kidneys!
❖ SWELLING HEART – CHF & HTN worsening
➢ Most over-the-counter NSAIDs contain Na+ which swells the body and lead to
worsening HTN.
➢ Clients with long-term HTN or Cardiovascular disease, SAY NO TO NSAIDs, if they are
taking NSAIDs, notify the HCP
➢ HESI question
▪ Patient with HTN or CHF: I will call my HCP before taking ibuprofen – TRUE
❖ ASPIRIN PATIENT TEACHING
➢ T – Toxicity
➢ T – Tinnitus, report to HCP! Earliest sign of Toxicity
➢ Tachycardia and Hypotension are usually bleeding symptoms, report to HCP
➢ A is for Aspirin so Avoid kids = possible Reye’s syndrome
▪ Never give a child any salicylate or bismuth subsalicylate (pepto-bismol) containing
medication – give them Tylenol or ibuprofen
Review -Analgesics & Anesthetics
Guidelines (Exam-Focused Study Guide)
, HESI PHARMACOLOGY BLUEPRINT
ANALGESICS AND SENSORY MEDICATIONS
❖ 2 types, non-opioids (non-sedating) and opioids (sedating, think low and slow)
❖ Non-opioids
➢ NSAIDs & Acetaminophen (Tylenol)
▪ Anti-pyretic (anti-fever)
▪ Anti-inflammatory (NSAIDS only)
▪ NOT a CNS depressant
▪ Vital signs will not be affected or “low and slow”
❖ SUFFIXES
➢ Opioids -done/-one
➢ NSAIDs (anti-inflammatory) -olac/-profen
➢ Salicylate -ASA
➢ Nonsalicylate -Acetaminophen
❖ NSAID examples:
➢ Remember NSAIK
▪ Naproxen - #1 NSAID given
▪ Salicylate acid (Aspirin)
▪ Acetylsalicylic acid (Aspirin)
▪ Ibuprofen & Indomethacin
▪ Ketorolac (brand: Toradol) only NSAID that can be given through IV
❖ Common HESI questions about analgesics
➢ Gout teaching is effective when your patient states what?
▪ “I can use Ibuprofen or Naproxen for pain relief”
➢ Patient with rheumatoid arthritis says they can use what for pain relief.
▪ “I can use NSAIDs to relieve the symptoms of my pain”
❖ Mechanism of action for NSAIDs
➢ NSAIDs decrease prostaglandin in response.
, ▪ To decrease pain and inflammation, think that Prostaglandins are like a big party
popper that basically puffs up the body and contributes to inflammation
▪ Decrease platelet aggregation, especially with aspirin which leads to a big risk for
bleeds
❖ NSAIDs are not good for the entire body
➢ GI. Bleeding – BAD for ulcers
➢ LUNGS – BAD for asthma
➢ Heart – HTN & Heart Failure
➢ Kidney clogging – increased Creat & BUN
➢ BLOOD clots
▪ KEY POINT
• NEVER TAKE 2 NSAIDS simultaneously
• Use the lowest dose for the shortest amount of time possible
❖ STICKY BLOOD CLOTS – Increased risk for thrombosis
➢ BAD for patients with CLOT HISTORY, MI, STROKE, DVT, PE
❖ ASTHMA WORSENING
➢ NSAIDs are NOT SAFE for ASTHMA and will make it worse
▪ HESI question
• Patients with asthma or nasal polyps
◆ “Use acetaminophen instead of NSAID”
❖ INCREASED BLEED RISK!
➢ NOTIFY HCP Bleeding
▪ Easy bruising
▪ Tarry stool and coffee-ground emesis = GI bleed
➢ AVOID – Peptic Ulcer patients, leading to GI bleeding
➢ Always take with food, never on an empty stomach
➢ If the patient is on an PPI, it is ok to use an NSAID
❖ BIG KEY POINT AVOID EGGO vitamins
➢ E – Vitamin E
, ➢ G – Gingko, Garlic
➢ O – Omega 3 oils
▪ mixed with those vitamins, it can cause an increased risk for bleeding
➢ HESI QUESTIONS
▪ Ibuprofen
• Do NOT take on an empty stomach
• Patient with Acid reflux on Ranitidine (PPI) & NSAID is ok
• It is ok to occasionally take ibuprofen for knee pain for a rheumatoid arthritis
patient
❖ DYSFUNCTIONAL KIDNEYS – Renal Injury = Long Term Use
➢ Memory Tricks
▪ Creatinine over 1.3 = BAD KIDNEY!
▪ Urine output 30 mL/hr or LESS = KIDNEYS in Distress!
▪ Ketorolac – KILLS the kidneys!
❖ SWELLING HEART – CHF & HTN worsening
➢ Most over-the-counter NSAIDs contain Na+ which swells the body and lead to
worsening HTN.
➢ Clients with long-term HTN or Cardiovascular disease, SAY NO TO NSAIDs, if they are
taking NSAIDs, notify the HCP
➢ HESI question
▪ Patient with HTN or CHF: I will call my HCP before taking ibuprofen – TRUE
❖ ASPIRIN PATIENT TEACHING
➢ T – Toxicity
➢ T – Tinnitus, report to HCP! Earliest sign of Toxicity
➢ Tachycardia and Hypotension are usually bleeding symptoms, report to HCP
➢ A is for Aspirin so Avoid kids = possible Reye’s syndrome
▪ Never give a child any salicylate or bismuth subsalicylate (pepto-bismol) containing
medication – give them Tylenol or ibuprofen
