NR565 Advanced Pharmacology (Pain Drugs) –
Questions With Verified Solutions
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Terms in this set (108)
Acute Pain - Occurs for less than three months and is often
precipitated by trauma, acute medical conditions,
surgery, or treatment.
- Subacute pain has a duration of 1-3 months.
- Categorized as referred pain, acute somatic pain,
or acute visceral pain.
- Rated by severity.
- The focus is on immediate relief and prevention of
transition to chronic pain, utilizing a variety of drugs.
Acute Pain and Opioids - Short-acting opioids should be used exclusively as
the treatment of acute pain in opioid-naive clients (as
opposed to opioid-tolerant clients).
- Titration to optimal therapeutic effects is faster,
safer, and easier with immediate-release opioids (as
opposed to extended-release opioids).
- Unintentional overdose may be more likely when
opioid therapy begins with long-acting opioids in
opioid-naive clients.
Chronic Pain - Persists beyond three months or the expected time
of healing.
- Treatment aims to alleviate pain and improve
function and quality of life over the long term.
- Agents used to manage chronic pain are often the
same ones used to manage acute pain. However, due
to the extended duration of use and increased
potential for serious risks, including misuse and
abuse, addiction, overdose, and death, these agents
must be used judiciously to avoid harm.
- Chronic pain is ideally treated without opioids.
,Nonpharmacological Treatments Examples: physical therapy, complementary
therapies like acupuncture, rest, ice, heat, etc.
- Crucial in a holistic pain management plan.
Essential Considerations for Safe Pain 1. Opioids are not first-line therapy
Management 2. Establish goals for pain and function
3. Discuss risks and benefits
4. Use immediate-release opioids when starting
5. Use the lowest effective dose
6. Prescribe short durations for acute pain
7. Evaluate benefits and harms frequently
8. Use strategies to mitigate risk
9. Review PDMP data
10. Use urine drug testing
11. Avoid concurrent opioid and benzodiazepine
prescribing
12. Offer treatment for opioid disorder
Management of Pain with Non- The CDC clinical practice guideline (CPG) for
Opioids prescribing non-opioids strongly recommends
considering non-opioid medications and
nonpharmacologic treatments for pain management
before prescribing opioids. This approach prioritizes
the prescription of non-opioid medications that can
effectively manage pain with a lower risk of addiction
and side effects. Non-opioid treatments encompass
a wide range of pharmacologic options (including
acetaminophen and non-steroidal anti-inflammatory
drugs (NSAIDs) and nonpharmacologic options
(including physical therapy, exercise, and cognitive
behavioral strategies) to address pain
comprehensively.
,Acetaminophen (Tylenol): Category, Category: Cyclooxygenase Inhibitors (Drugs that
Primary Function, Unique Features Lack Anti-inflammatory Actions)
Primary Function: Acetaminophen reduces
prostaglandin synthesis in the CNS to reduce pain
and fever.
Unique Features: Acetaminophen is used more than
any other analgesic.
Acetaminophen (Tylenol): MOA Acetaminophen reduces prostaglandin synthesis in
the CNS to reduce pain and fever. While
acetaminophen is mostly transformed into safe
metabolites after metabolism, liver enzymes convert
a small part into a harmful substance. Normally, this
dangerous byproduct is quickly neutralized, but in
cases of overdose, it accumulates and can severely
damage the liver due to the depletion of protective
glutathione.
Acetaminophen (Tylenol): Indications - Pain Relief: Acetaminophen is used when mild pain
and Therapeutic Uses relief is needed across a range of indications.
- Fever: Acetaminophen can be used to reduce fever.
Acetaminophen (Tylenol): Side Effects - Hypertension
and Adverse Reactions - Hepatotoxicity
- Rash: Stevens-Johnson Syndrome (SJS), acute
generalized exanthematous pustulosis (AGEP), or
toxic epidermal necrolysis (TEN)
Acetaminophen (Tylenol): Precautions
Precautions, Contraindications, Black - Monitor for hepatic dysfunction.
Box Warning - Caution with clients who consume three or more
alcoholic drinks daily.
- Administering acetylcysteine (Mucomyst) for
overdose can reduce liver injury.
Contraindications
- Contraindicated in clients with hepatic impairment.
- Contraindicated in clients who consume high
amounts of alcohol.
Black Box Warning
- Serious liver injury can result from acetaminophen.
, Acetaminophen (Tylenol): Drug - Alcohol consumption
Interactions - Warfarin
- Vaccines (blunt response)
Acetaminophen (Tylenol): Dosing - Dosing varies based on the condition, severity, and
client response.
- Check drug dosing guidelines for individualized
dosing.
- Oral (tablet or solution) or rectal dosing.
- Do not use in clients with liver impairment due to
the risk for hepatotoxicity.
- Monitor daily dose of acetaminophen as many
other products (cold and flu medications, other pain
medication combination drugs, etc.) also contain
acetaminophen. The maximum daily dose is
3900mg/day.
- Administering acetylcysteine (Mucomyst) for
overdose can reduce liver injury.
Acetaminophen (Tylenol): Administration
Administration and Client Teaching - Administer orally or rectally.
Client Teaching
- Advise clients to assess over-the-counter
medications for acetaminophen and monitor the daily
amount. 3900mg/day is the maximum amount.
- Advise clients to avoid alcohol.
- Advise clients to only consume 2000mg/day if they
drink more than 3 alcoholic beverages per day.
Acetaminophen (Tylenol): Labs to Liver Function Tests (LFTs)
Monitor Regular liver function tests may be required for
certain clients due to the potential for liver injury.
Questions With Verified Solutions
Save Groups
Terms in this set (108)
Acute Pain - Occurs for less than three months and is often
precipitated by trauma, acute medical conditions,
surgery, or treatment.
- Subacute pain has a duration of 1-3 months.
- Categorized as referred pain, acute somatic pain,
or acute visceral pain.
- Rated by severity.
- The focus is on immediate relief and prevention of
transition to chronic pain, utilizing a variety of drugs.
Acute Pain and Opioids - Short-acting opioids should be used exclusively as
the treatment of acute pain in opioid-naive clients (as
opposed to opioid-tolerant clients).
- Titration to optimal therapeutic effects is faster,
safer, and easier with immediate-release opioids (as
opposed to extended-release opioids).
- Unintentional overdose may be more likely when
opioid therapy begins with long-acting opioids in
opioid-naive clients.
Chronic Pain - Persists beyond three months or the expected time
of healing.
- Treatment aims to alleviate pain and improve
function and quality of life over the long term.
- Agents used to manage chronic pain are often the
same ones used to manage acute pain. However, due
to the extended duration of use and increased
potential for serious risks, including misuse and
abuse, addiction, overdose, and death, these agents
must be used judiciously to avoid harm.
- Chronic pain is ideally treated without opioids.
,Nonpharmacological Treatments Examples: physical therapy, complementary
therapies like acupuncture, rest, ice, heat, etc.
- Crucial in a holistic pain management plan.
Essential Considerations for Safe Pain 1. Opioids are not first-line therapy
Management 2. Establish goals for pain and function
3. Discuss risks and benefits
4. Use immediate-release opioids when starting
5. Use the lowest effective dose
6. Prescribe short durations for acute pain
7. Evaluate benefits and harms frequently
8. Use strategies to mitigate risk
9. Review PDMP data
10. Use urine drug testing
11. Avoid concurrent opioid and benzodiazepine
prescribing
12. Offer treatment for opioid disorder
Management of Pain with Non- The CDC clinical practice guideline (CPG) for
Opioids prescribing non-opioids strongly recommends
considering non-opioid medications and
nonpharmacologic treatments for pain management
before prescribing opioids. This approach prioritizes
the prescription of non-opioid medications that can
effectively manage pain with a lower risk of addiction
and side effects. Non-opioid treatments encompass
a wide range of pharmacologic options (including
acetaminophen and non-steroidal anti-inflammatory
drugs (NSAIDs) and nonpharmacologic options
(including physical therapy, exercise, and cognitive
behavioral strategies) to address pain
comprehensively.
,Acetaminophen (Tylenol): Category, Category: Cyclooxygenase Inhibitors (Drugs that
Primary Function, Unique Features Lack Anti-inflammatory Actions)
Primary Function: Acetaminophen reduces
prostaglandin synthesis in the CNS to reduce pain
and fever.
Unique Features: Acetaminophen is used more than
any other analgesic.
Acetaminophen (Tylenol): MOA Acetaminophen reduces prostaglandin synthesis in
the CNS to reduce pain and fever. While
acetaminophen is mostly transformed into safe
metabolites after metabolism, liver enzymes convert
a small part into a harmful substance. Normally, this
dangerous byproduct is quickly neutralized, but in
cases of overdose, it accumulates and can severely
damage the liver due to the depletion of protective
glutathione.
Acetaminophen (Tylenol): Indications - Pain Relief: Acetaminophen is used when mild pain
and Therapeutic Uses relief is needed across a range of indications.
- Fever: Acetaminophen can be used to reduce fever.
Acetaminophen (Tylenol): Side Effects - Hypertension
and Adverse Reactions - Hepatotoxicity
- Rash: Stevens-Johnson Syndrome (SJS), acute
generalized exanthematous pustulosis (AGEP), or
toxic epidermal necrolysis (TEN)
Acetaminophen (Tylenol): Precautions
Precautions, Contraindications, Black - Monitor for hepatic dysfunction.
Box Warning - Caution with clients who consume three or more
alcoholic drinks daily.
- Administering acetylcysteine (Mucomyst) for
overdose can reduce liver injury.
Contraindications
- Contraindicated in clients with hepatic impairment.
- Contraindicated in clients who consume high
amounts of alcohol.
Black Box Warning
- Serious liver injury can result from acetaminophen.
, Acetaminophen (Tylenol): Drug - Alcohol consumption
Interactions - Warfarin
- Vaccines (blunt response)
Acetaminophen (Tylenol): Dosing - Dosing varies based on the condition, severity, and
client response.
- Check drug dosing guidelines for individualized
dosing.
- Oral (tablet or solution) or rectal dosing.
- Do not use in clients with liver impairment due to
the risk for hepatotoxicity.
- Monitor daily dose of acetaminophen as many
other products (cold and flu medications, other pain
medication combination drugs, etc.) also contain
acetaminophen. The maximum daily dose is
3900mg/day.
- Administering acetylcysteine (Mucomyst) for
overdose can reduce liver injury.
Acetaminophen (Tylenol): Administration
Administration and Client Teaching - Administer orally or rectally.
Client Teaching
- Advise clients to assess over-the-counter
medications for acetaminophen and monitor the daily
amount. 3900mg/day is the maximum amount.
- Advise clients to avoid alcohol.
- Advise clients to only consume 2000mg/day if they
drink more than 3 alcoholic beverages per day.
Acetaminophen (Tylenol): Labs to Liver Function Tests (LFTs)
Monitor Regular liver function tests may be required for
certain clients due to the potential for liver injury.
