Pharm Final Exam Part 2
Common NSAIDs *** 1. aspirin
2. ibuprofen
3. naproxen
4. ketorolac
(AINK)
How much ibuprofen is appropriate to give *** MAX dose is 3200 mg a day for an adult (this goes for all
NSAIDS)
Purpose of NSAIDs *** - decreased inflammation
- cure mild to moderate pain
- decreased fever
- decreased platelet aggregation (this will decrease blood clots that would cause a stroke and myocardial
infarction - aspirin)
Complications of NSAIDs *** -GI issues/bleeding(dark colored stool, vomiting, nausea)
- IMPAIRED KIDNEY function - Nephrotoxic
- increased risk of M.I. and stroke (non-aspirin NSAIDs)
- Salicylism (occurs when taking aspirin) symptoms include: tinnitus(hearing ringing sounds), respiratory
alkalosis
- Reye's Syndrome (caused when aspirin is given to children, so DONT give aspirin to children)
Take NSAIDs with *** milk or food or 8oz glass of water to reduce gastric discomfort
,what can we do to get the aspirin toxicity out of your system? *** Activated Charcoal is the NSAID
antidote
also can use:
- gastric Lavage(pumping stomach)
- sodium bicarbonate
- if it gets bad enough hemodialysis
Acetaminophen *** Analgesic - relief of pain
Antipyretic - reduce fever
(can take with or without food)
What is the drug of choice for fever reduction in CHILDREN? *** Acetaminophen
Complications of Acetaminophen *** liver damage
early symptoms : nausea, vomiting, diarrhea, sweating, abdominal discomfort
Late symptoms: Jaundice, yellow sclera
severe: hepatic failure, coma, death
Recommended doses for Acetaminophen *** - most patients - 4g a day
- Undernourished/older patients - 3g a day
- Patients who consume 3+ servings of alcohol daily - 2g a day
Antidote for Acetaminophen *** acetylcysteine (smells like rotten eggs)
Contraindications of Acetaminophen *** in pregnant woman: ruins formation of fetus
avoid patients with: liver damage, kidney issues, alcohol use(increases liver damage), and malnutrition
, Opioid Agonists - Morphine purpose *** - treats moderate to severe pain
- sedation
- relief of diarrhea
Complications of Opioid Agonists *** - NARCS U
- orthostatic hypotension
- cough suppression
- biliary colic (blockage of bile duct in the stomach)
- opioid toxicity triad (coma, respiratory depression, pinpoint pupils)
Nursing Admin for Opioid Agonists *** - Assess pain
- double check doses with a second nurse
- do not stop opioids abruptly
- closely monitor Patient Controlled Analgesia settings (PCA= only PATIENT can push the button on the
machine)
NARCSU *** N- nausea
A - Acute Toxicity
R- respiratory depression
C - Constipation
S - sedation
U - Urinary retention
Antidote for Opioids *** Naloxone
Common NSAIDs *** 1. aspirin
2. ibuprofen
3. naproxen
4. ketorolac
(AINK)
How much ibuprofen is appropriate to give *** MAX dose is 3200 mg a day for an adult (this goes for all
NSAIDS)
Purpose of NSAIDs *** - decreased inflammation
- cure mild to moderate pain
- decreased fever
- decreased platelet aggregation (this will decrease blood clots that would cause a stroke and myocardial
infarction - aspirin)
Complications of NSAIDs *** -GI issues/bleeding(dark colored stool, vomiting, nausea)
- IMPAIRED KIDNEY function - Nephrotoxic
- increased risk of M.I. and stroke (non-aspirin NSAIDs)
- Salicylism (occurs when taking aspirin) symptoms include: tinnitus(hearing ringing sounds), respiratory
alkalosis
- Reye's Syndrome (caused when aspirin is given to children, so DONT give aspirin to children)
Take NSAIDs with *** milk or food or 8oz glass of water to reduce gastric discomfort
,what can we do to get the aspirin toxicity out of your system? *** Activated Charcoal is the NSAID
antidote
also can use:
- gastric Lavage(pumping stomach)
- sodium bicarbonate
- if it gets bad enough hemodialysis
Acetaminophen *** Analgesic - relief of pain
Antipyretic - reduce fever
(can take with or without food)
What is the drug of choice for fever reduction in CHILDREN? *** Acetaminophen
Complications of Acetaminophen *** liver damage
early symptoms : nausea, vomiting, diarrhea, sweating, abdominal discomfort
Late symptoms: Jaundice, yellow sclera
severe: hepatic failure, coma, death
Recommended doses for Acetaminophen *** - most patients - 4g a day
- Undernourished/older patients - 3g a day
- Patients who consume 3+ servings of alcohol daily - 2g a day
Antidote for Acetaminophen *** acetylcysteine (smells like rotten eggs)
Contraindications of Acetaminophen *** in pregnant woman: ruins formation of fetus
avoid patients with: liver damage, kidney issues, alcohol use(increases liver damage), and malnutrition
, Opioid Agonists - Morphine purpose *** - treats moderate to severe pain
- sedation
- relief of diarrhea
Complications of Opioid Agonists *** - NARCS U
- orthostatic hypotension
- cough suppression
- biliary colic (blockage of bile duct in the stomach)
- opioid toxicity triad (coma, respiratory depression, pinpoint pupils)
Nursing Admin for Opioid Agonists *** - Assess pain
- double check doses with a second nurse
- do not stop opioids abruptly
- closely monitor Patient Controlled Analgesia settings (PCA= only PATIENT can push the button on the
machine)
NARCSU *** N- nausea
A - Acute Toxicity
R- respiratory depression
C - Constipation
S - sedation
U - Urinary retention
Antidote for Opioids *** Naloxone
