1
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- Most common reason people seek health care
- Tissue damage activates free nerve endings (pain receptors)
- Generally indicates tissue damage
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2
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- Strongest pain producing substances
- May be involved in acute pain
- Prostglandins increase sensitivity to pain
- Chemical mediators activate and sensitize pain receptors or stimulate
the release of pain producing substances
- Table 9-1, p 121
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3
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4
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- Activated by nerve signals or by morphine-like substances entering the
brain
- Opiate receptors
- Endogenous peptides
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5
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- Moderate to severe pain
- Reduction of pain sensation
- Sedation
- Decreases emotional upset
- Most are schedule II
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6
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- Oral, IM, SQ, & IV
- PO requires high doses
- Prevent or relieve acute or chronic pain
- Bind to opioid receptors in the brain and spinal cord and activate the
endogenous system
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7
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- Agonist-binds to a receptor site and causes a response
- Partial agonist-binds to a receptor and causes only limited actions
- Antagonist-bind to a receptor and produce no response
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8
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- Morphine and morphine like drugs
- Activity at Mu, Kappa, & ??? Delta receptors
- Severe & Chronic Pain
- IV, IM, SQ, Suppository, Epidural,&, PO
- Impaired kidney function may cause prolonged drug action and
accumulation
- Nonceiling drug
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9
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- PO onset 15-30 minutes duration 4-6 hours
- Naturally occurring opium alkaloid
- Antitussive
- Analgesic
- Milder adverse effects than morphine
- May be combined with Acetaminophen
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10
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- Respiratory depression
- Chronic lung disease
- Liver or kidney disease
- Prostatic hypertrophy
- Increased ICP
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11
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- Agonist activity at some sites and antagonist at others
- Low abuse potential
- Potent analgesics
- May produce withdrawal symptoms in those with opiate dependence
- Synthetic
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12
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- Reverse or block analgesia, respiratory depression
- Onset within minutes and last 1-2 hours
- Shorter duration than opioids
- May give repeated injections
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13
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14
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- Anxiety, aggressiveness, restlessness, lacrimation, rhinorhea,
perspiration, pupil dilation, piloerection, elevated body temp,
diarrhea, BP
- Begin within few hours of last dose
- Early recognition and treatment key
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15
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- Respiratory depression
- Hypotension
- N & V
- Constipation
- Monitor respirations
- Orthostatic pressures
- BP
- Bowel regimen
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16
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- No Etoh
- Do not increase dose
- Stay in bed 30-60 minutes after receiving
- No heavy machinery
- High fiber foods & increase fluids
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17
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- Analgesic, Antipyretic, &
- Anti-inflammatory Drugs
- Acetylsalic Acid (Aspirin)
- Acetominophen (Tylenol)
- Ibuprofen (Motrin)
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18
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- Inhibits the synthesis of prostaglandins
- Non selective COX inhibitor
- Antiplatelet and Antipyretic
- Prevent sensitization of pain receptors to various chemical substances
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19
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- PUD
- GI or other bleeding disorders
- Hypersensitivity
- Impaired renal function
- Children with viral infections
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20
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- Does not cause N & V or GI bleeding
- Does not interfere with clotting
- Lacks anti-inflammatory activity
- Metabolized in liver
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21
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- Anti-inflammatory agent
- OTC
- May be better tolerated than aspirin but work in a similar fashion
- Hypersensitivity may occur in people with allergy to aspirin
- Contraindications similar to ASA (except Reye’s)
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22
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- Designed to relieve pain, fever,
and inflammation
- Fewer side effects than older NSAIDS
- Contraindicated with ulcers, GI bleeds, asthma, severe renal impairment,
& allergy to other NSAIDS
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23
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- Antidote to Acetaminophen overdose
- Give PO
- Must be given within 24 hours
- Bad smell
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24
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- May be given for an overdose of Acetaminophen
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25
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- Relieves HA, fever, and menstrual irregularities
- Can increase bleeding with aspirin, dipyridamole, warfarin
- Contraindicated in pregnant patients, breastfeeding, and children < 2
y/o
- http://www.merck.com/pubs/mmanual_home2/sec02/ch019/ch019a.htm
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