Medical-Surgical Nursing, 9th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid
Pain Assessment
- Acute Pain
- Chronic Pain
- Onset
- Provoking or Palliative
- Quality
- Radiation
- Severity
- Timing
- Subjective Findings
- Objective Findings
- Reassessment of Pain
Acetaminophen
- Fever
- Pain
- Reversibly Inhibits COX
- Acts Primarily in CNS
- Hepatic Necrosis
- N-acetylcysteine Antidote
Aspirin (Acetylsalicylic Acid)
- Inhibits Platelet Aggregation
- NSAID
- Thrombotic Event Prevention
- General Pain
- Inflammatory Conditions
- Fever
- Pancytopenia
- GI Ulcers
- Bleeding
- Withhold Before Surgery 7-10 Days
- Reye's Syndrome
NSAIDs
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
Ibuprofen (Advil, Motrin)
- NSAID
- COX Inhibitor
- General Pain
- Fever
- Inflammatory Conditions
- GI Ulcers
- Nephrotoxicity
- Rash
- Avoid with Alcohol
- Risk of Thrombotic Event
Celecoxib
- Rheumatoid Arthritis
- Osteoarthritis
- Pain
- NSAID
- Selectively Inhibits COX-2
- Sulfa Allergy
- Increased Risk of Thrombosis
- GI Bleed
- Pregnancy > 30 Weeks
Morphine
- Opioid Receptor Agonist
- Pain
- Myocardial Infarction
- Nausea and Vomiting
- CNS Depression
- Biliary Colic
- Constipation
- Increased Intracranial Pressure (ICP)
- Pupillary Constriction
- Hypotension
Codeine
- Opioid Receptor Agonist
- Mild to Moderate Pain
- Cough Suppressant
- Sedation
- Constipation
- Miosis
- Close Monitoring When Breast Feeding
- Often Combined with Non-Opioids
Butorphanol
- Migraine
- Severe Pain
- Labor
- Partial Agonist at Mu and Full Agonist at Kappa Receptors
- Less Respiratory Depression
- Withdrawal Symptoms
Meperidine (Demerol)
- Opioid Receptor Agonist
- Moderate to Severe Pain
- Post Anesthesia Shivering
- Tremors
- Constipation
- CNS Depression
- Sedation
- Short Term Administration
- Increased Risk Serotonin Syndrome
- Does NOT cause Miosis
- Renal Failure Increases Toxicity Risk
Naloxone (Narcan)
- Competitive Opioid Receptor Antagonist
- Opioid Induced CNS Depression
- Severe Nausea and Vomiting
- Excitable State
- Opioid Withdrawal Symptoms
- Repeated Dosing Often Required
Tricyclic Antidepressants (TCAs) Indications
- Major Depression
- Bedwetting
- Fibromyalgia
- OCD
- -Iptyline or -Ipramine Suffix
- Amitriptyline
- Desipramine
- Clomipramine
- Imipramine
- Nortriptyline
Tricyclic Antidepressants (TCAs)
- Inhibits Reuptake of Norepinephrine and Serotonin
- Depression
- Bipolar Disorder
- Fibromyalgia
- Sedation
- Orthostatic Hypotension
- Anticholinergic Effects
- Cardiac Toxicity
- Delayed Effect
- Do Not Stop Abruptly
Tricyclic Antidepressant (TCA) Antidote
- Sodium Bicarbonate (NaHCO3)
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
- Depression
- Diabetic Peripheral Neuropathy
- Duloxetine
- Panic and Anxiety
- Venlafaxine
- Inhibits Reuptake of Serotonin and NE
- Hypertension
- Insomnia
- Nausea and Vomiting
- Decreased Libido
Carbamazepine (Tegretol)
- Inactivates Na+ Channels
- Seizures
- Bipolar Disorder
- Trigeminal Neuralgia
- Nystagmus
- Ataxia
- Hepatotoxicity
- Blood Dyscrasias
- Water Retention
- Stevens-Johnson Syndrome
- Avoid Grapefruit Juice
Phenytoin (Dilantin)
- Blocks Na+ Channels
- Tonic-clonic Seizures
- Ataxia
- Nystagmus
- Sedation
- Gingival Hyperplasia
- Purple Glove Syndrome
- Hirsutism
- Rash
- Anemia
- Individualized Dosing
Pregabalin (Lyrica)
- GABA Analog
- Seizures
- Neuropathic Pain
- Fibromyalgia
- Headache
- Dizziness
- Somnolence (Fatigue)
- Weight Gain
- Angioedema
- Rhabdomyolysis
- Dependence
Lamotrigine (Lamictal)
- Blocks Na+ Channels
- Seizures
- Bipolar Disorder
- Diplopia
- Stevens-Johnson Syndrome
- Headache
- Aseptic Meningitis
- Nausea and Vomiting
- Screen for Suicide Risk
Gabapentin
- Seizure Treatment
- Peripheral Neuropathy
- Postherpetic Neuralgia
- Bipolar Disorder
- Migraine Prophylaxis
- Inhibits Voltage-Gated Ca2+ channels
- Designed as a GABA Analog
- Ataxia
- Sedation
Local Anesthetic Overview
- Minor Procedures
- Epidurals
- Blocks Na+ Channels
- State Dependent
- Combined with Vasoconstrictors
- Infected Tissue Requires Higher Dose
- Esters
- Amides
- Arrhythmias
- Cardiotoxicity
Lidocaine
- Blocks Na+ Channels
- Ventricular Arrhythmia
- Anesthetic
- Paresthesias
- Seizures
- Respiratory Depression
- Drowsiness
- Anesthetic Effects Extended with Epinephrine
IV Anesthetics
- Barbiturates
- Benzodiazepines
- Respiratory Depression
- Hypotension
- Ketamine
- NMDA Receptor Antagonist
- Hallucinations
- Opioids
- Propofol
- Potentiates GABA-A
Routes of Administration Part One
- Oral
- Sublingual
- Buccal
- Rectal
- Tubes
- Transdermal
- Drops/Spray
- Vaginal
- Inhalation
Routes of Administration Part Two (Parenteral)
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal