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Analgesics
Opioids Overview
Indications
Pain
Weaning
Cough
Diarrhea
Mechanism of Action
Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
Decrease Synaptic Transmission
Side Effects
Respiratory Depression
Addiction
Miosis
Constipation
2 mins
Opioid Antidote
Antidote
Naloxone
29 secs
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
2 mins
Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
48 secs
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
2 mins
Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
2 mins
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
1 min
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
2 mins
Aspirin Poisoning (Salicylism) Assessment
Early Symptoms
Nausea and Vomiting
Tinnitus
Confusion
Hyperventilation
Respiratory Alkalosis
Late Symptoms
Metabolic Acidosis
Coma
Hyperthermia
1 min
Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
51 secs
Acetaminophen Antidote
Antidote
N-Acetylcysteine
33 secs
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
1 min
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
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