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Questions and Answers
Which Tylenol formulation contains the highest amount of codeine phosphate?
Which Tylenol formulation contains the highest amount of codeine phosphate?
What is a common side effect of morphine?
What is a common side effect of morphine?
How long does it typically take for antidepressants to achieve a therapeutic effect?
How long does it typically take for antidepressants to achieve a therapeutic effect?
What is the antidote for benzodiazepine overdose?
What is the antidote for benzodiazepine overdose?
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Which of the following is NOT an indication for benzodiazepines?
Which of the following is NOT an indication for benzodiazepines?
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What should be done before and after IV administration of morphine?
What should be done before and after IV administration of morphine?
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Which of the following is a common side effect of tricyclic antidepressants?
Which of the following is a common side effect of tricyclic antidepressants?
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Which of the following benzodiazepines is commonly used for procedural sedation?
Which of the following benzodiazepines is commonly used for procedural sedation?
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Why is it recommended that analgesics are administered before pain becomes severe?
Why is it recommended that analgesics are administered before pain becomes severe?
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What is a significant side effect of acetaminophen overdose?
What is a significant side effect of acetaminophen overdose?
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What category do opioids like morphine and codeine fall under?
What category do opioids like morphine and codeine fall under?
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What should patients taking NSAIDs be cautious about?
What should patients taking NSAIDs be cautious about?
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Which of the following opioids is primarily used for mild to moderate pain?
Which of the following opioids is primarily used for mild to moderate pain?
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What is a common adverse effect of opioid analgesics?
What is a common adverse effect of opioid analgesics?
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What important instruction should be provided to patients taking Acetylsalicylic acid (Aspirin)?
What important instruction should be provided to patients taking Acetylsalicylic acid (Aspirin)?
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What is the maximum daily dosage recommended for acetaminophen to prevent toxicity?
What is the maximum daily dosage recommended for acetaminophen to prevent toxicity?
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Study Notes
General Information
- Pain management is most effective when analgesics are administered before pain becomes severe.
- Opioids are categorized based on their potential for abuse.
- Schedule 1 drugs, such as heroin, have a high potential for abuse.
- Schedule 2-5 drugs are controlled substances under the Controlled Substance Act of 1970.
- All controlled substances must be accounted for by licensed personnel.
- Waste must be witnessed and co-signed by another licensed individual.
Non-Opioid Analgesics; Antipyretics
Acetylsalicylic acid (Aspirin)
- Aspirin has anti-inflammatory, anticoagulant, analgesic, and antipyretic properties.
- It inhibits prostaglandin synthesis.
- Aspirin can irritate the gastric mucosa.
- Patients should take aspirin with milk or food.
- Caution is advised for patients with peptic ulcers.
- High risk of bleeding exists when taken with anticoagulants.
- Tinnitus (ringing in the ears) is a sign of aspirin toxicity.
Acetaminophen (Tylenol)
- Acetaminophen does not irritate the gastric mucosa.
- Acetaminophen has analgesic and antipyretic properties.
- Liver damage can occur due to acetaminophen toxicity.
- The maximum recommended daily dose is 4 grams.
- Check for other sources of acetaminophen in over-the-counter medications.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
- NSAIDs include Ibuprofen (Motrin), Naproxen (Naprosyn), Indocin (Indomethacin), and Ketorolac (Toradol).
- NSAIDs have anti-inflammatory, analgesic, and antipyretic effects.
- NSAIDs can irritate the gastric mucosa.
- Patients should take NSAIDs with milk or food.
- Use caution with patients with a history of peptic ulcers.
- NSAIDs affect coagulation (platelet aggregation).
- Use cautiously with the elderly.
- Use the lowest effective dose for the shortest possible period in the elderly.
- Avoid taking over-the-counter medications while taking NSAIDs.
- Avoid taking NSAIDs with ACE Inhibitors.
Opioid Analgesics
- Opioids include Codeine, morphine, opium, and various opium derivatives.
- Respiratory depression can occur in elderly patients.
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Codeine:
- Used for mild to moderate pain.
- Duration of action is 4-6 hours.
- Can cause constipation.
- Common side effects include dizziness and sedation.
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Combination Dosage Forms (Tylenol #1-4):
- Contains acetaminophen and codeine phosphate in various strengths.
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Morphine:
- Used for moderate to severe pain, both acute and chronic.
- Common side effects include nausea, vomiting, sedation, and dizziness.
- Morphine is versatile and can be administered via various routes.
- IV push should be administered slowly over 4-5 minutes per 15mg.
- Dilute morphine before IV administration.
- Do not mix morphine with other drug solutions as it can form a precipitate.
- Flush tubing thoroughly with 0.9% saline before and after IV administration.
- Do not use dextrose solutions.
- Use an inline filter to collect particulate matter.
Benzodiazepines
- Benzodiazepines include Lorazepam (Ativan), Diazepam (Valium), Alprazolam (Xanax), Triazolam (Halcion), Midazolam (Versed), and Temazepam (Restoril).
- They are sedative/hypnotic medications.
- Indications for benzodiazepines include:
- Anxiety.
- Sedation.
- Alcohol withdrawal treatment or prevention.
- Seizure or status epilepticus treatment.
- Nausea.
- Muscle spasm.
- Benzodiazepines are available orally or as injections/infusions.
- Adverse reactions include:
- Drowsiness.
- Confusion.
- Lethargy.
- Ataxia.
- Respiratory depression.
- Increased intraocular pressure.
- Administer cautiously with other CNS depressants.
- Monitor patients closely for effects.
- Benzodiazepines have potential for abuse, misuse, and addiction.
- Consider tapering the dose to prevent withdrawal symptoms.
- Flumazenil is the antidote for benzodiazepines.
Antidepressants
- Tricyclic Antidepressants: Amitriptyline (Elavil), Trazodone (Desyrel).
- Serotonin Reuptake Inhibitors: Fluoxetine (Prozac), Sertraline Hydrochloride (Zoloft).
- Selective Serotonin Reuptake Inhibitors (SSRIs): Lexapro (Escitalopram), Paroxetine (Paxil), Venlafaxine (Effexor), Citalopram (Celexa).
- Antidepressants take 3-4 weeks to achieve therapeutic effects.
- Overdose symptoms include CNS signs (confusion, agitation), autonomic effects (dilated pupils, flushing, hyperpyrexia), and cardiovascular signs (tachycardia, arrhythmias, hypotension).
- Common side effects include sedation, atropine-like reactions (dry mouth, blurred vision, tachycardia), rash, urticaria, and constipation.
- Advise patients not to abruptly stop taking antidepressants.
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Description
This quiz covers essential information about pain management, focusing on the use and classification of analgesics, including opioids and non-opioid options like aspirin and acetaminophen. Learn about the effects, risks, and proper administration of these medications to enhance patient care and safety.
