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NCLEX Cheat Sheet Analgesics

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Analgesics 1. Drug Classes Medications used to treat pain are either nonopioid, opioid, or adjuvant analgesics: 1. Nonopioid analgesics: y For mild to moderate pain y Most are available over the counter (OTC). 2. Opioid analgesics: y For moderate to severe pain y Have potential for tolerance, dependence, and abuse 3. Adjuvant drugs: y Medications from other classes that also have analgesic properties (e.g., antidepressants, muscle relaxants). 2. Nursing Considerations y For better pain control with fewer adverse effects, alternate analgesics from different classes. y Pain is easier to prevent than to treat:  Premedicate before painful procedures (wound care, physical therapy). y Treat chronic pain with scheduled analgesics given around the clock rather than “as-needed” only. y Example: Give PO acetaminophen every 6 hours around the clock plus IV morphine PRN for breakthrough pain. y Assess pain before and after giving an analgesic using a numeric pain score:  Reassess within 60 min of giving PO.  Reassess within 30 min of giving IV. y Use analgesics in combination with nonpharmacologic interventions (ice, heat).  Never administer a placebo (like saline) for pain. 3. Nonopioid Analgesics Nonopioids inhibit prostaglandin synthesis  Block pain and fever signals in the central or peripheral nervous systems (CNS or PNS) Medications (see TABLE 3): y Acetaminophen (works in the CNS) y Treats pain and fever y Aspirin and other NSAIDs (work in the PNS) y Treat pain, fever, and inflammation (e.g., from arthritis, sprains) y Aspirin has additional antiplatelet effects and is used to prevent stroke and MI. 4. Acetaminophen FIGURE 1. ACETAMINOPHEN A

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NCLEX Cheat Sheet Analgesics

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Table of Contents:
1. Drug Classes
4. Acetaminophen
2. Nursing
5. NSAIDs
Considerations
6. Opioid Analgesics
3. Nonopioid
Analgesics



Analgesics
1. Drug Classes
3. Nonopioid Analgesics
Medications used to treat pain are either
Nonopioids inhibit prostaglandin synthesis 
nonopioid, opioid, or adjuvant analgesics:
Block pain and fever signals in the central or
1. Nonopioid analgesics: peripheral nervous systems (CNS or PNS)
 For mild to moderate pain Medications (see TABLE 3):
 Most are available over the counter
(OTC).  Acetaminophen (works in the CNS)
 Treats pain and fever
2. Opioid analgesics:
 Aspirin and other NSAIDs (work in the PNS)
 For moderate to severe pain
 Treat pain, fever, and inflammation (e.g.,
 Have potential for tolerance,
from arthritis, sprains)
dependence, and abuse
 Aspirin has additional antiplatelet effects
3. Adjuvant drugs: and is used to prevent stroke and MI.
 Medications from other classes that also
have analgesic properties (e.g., 4. Acetaminophen
antidepressants, muscle relaxants).
FIGURE 1. ACETAMINOPHEN AT A GLANCE

2. Nursing Considerations
 For better pain control with fewer adverse
effects,
alternate analgesics from different classes.
 Pain is easier to prevent than to treat:
Premedicate before painful procedures
(wound care, physical therapy).
 Treat chronic pain with scheduled
analgesics given around the clock rather
than Acetaminophen (FIGURE 1):
“as-needed” only.  Preferred analgesic in clients at risk for
 Example: Give PO acetaminophen NSAID-related complications (GI toxicity,
every bleeding)
6 hours around the clock plus IV  Has no anti-inflammatory effects
morphine PRN for breakthrough pain. Use NSAIDs instead for arthritis or gout pain.
 Assess pain before and after giving an  Extensively metabolized in the liver  Risk for
analgesic using a numeric pain score: hepatotoxicity:
Reassess within 60 min of giving PO. Avoid in clients with liver disease or
Reassess within 30 min of giving IV. alcoholism.
 Use analgesics in combination with  Teach client to limit alcohol intake.
nonpharmacologic interventions (ice, heat). Monitor forin liver enzymes (AST, ALT, ALP).
Never administer a placebo (like saline) for pain.

, Avoid acetaminophen in clients with liver disease or alcoholism due to the risk for hepatotoxicity.
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