ATI Pain and Inflammation Study Cards

What are the pain mediating chemicals found in the body?
Substance P, prostaglandins, bradykinins, and histamine

What does the body produce and release in response to pain?
Body releases serotonin and produces enkephalins and endorphins which bind to opioid receptors

What are the 3 opioid receptors?
Mu, Kappa and Delta

What are the substances that increase pain transmission and cause an inflammatory response in the body?
Substance P, prostaglandins, bradkykinins and histamine

What are the substances that decrease pain transmission and produce analgesia?
Serotonin, endorphins and enkephalins

What are the different types of pharmacologic analgesics?
NSAIDS and opioids

What do NSAIDS do?
They interfere with the production of prostaglandins, which in turn inhibits mild pain and suppresses inflammation

What do opioids do?
Stimulate opioid receptors (mu, kappa and delta)

What are the types of anti-inflammatories?
Glucocorticoid and uricosurics

What do glucocorticoids do?
They produce a very strong anti-inflammatory effect especially in high doses

What do uricosurics do?
They decrease the serum levels of uric acid, a chemical in the body that can cause gout

What are the 3 categories of drugs that support the treatment of pain?
1. nonopioid analgesics
2. Opioid analgesics
3. Opioid antagonists

What are the 4 types of nonopijoid analgesics that treat pain?
1. first-generation non steroidal anti-inflammatory drugs (NSAIDS) – COX – 1 and COX -2 inhibitors
2. Second generation NSAIDS – COX-2 inhibitors
3. Acetaminophen
4. Centrally acting nonopioids

What is Aspirin classified as?
What does it do?
It inhibits platelet aggregation to suppress inflammation, analgesia for mild to moderate pain, reduces fever and dysmenorrhea

What does COX-1 do?
It is an enzyme that stimulates the release of prostaglandins

What does COX-2 do?
It stimulates the release of prostaglandins in response to injury

What are the side effects of COX-1&2 inhibitors?
Gastric upset, heartburn, nausea, gastric ulceration, bleeding, kidney dysfunction, salicylism, Reye’s syndrome, and thromboembolic events

What is Salicylism?
The build up of aspirin in the body causing toxicity

What is Reye’s syndrome?
the result of giving aspirin to a child who has a viral condition

What is the prototype for COX-2 inhibitors only?
Celecoxib (Celebrex)

What are side effects of celebrex?
Gastric upset, diarrhea, heartburn, nausea, gastric ulceration, renal dysfuncition, and cardiovascular and cerebrovascular events

Does acetaminophen have anti-inflammatory properties?
No, it only treats mild pain and fever

What are adverse effects of acetaminophen?
liver damage and hypertension

What is the prototype for centrally acting nonopioids?
Tramadol (ultram)

What does Tramadol do?
binds to selected opioid receptors and blocks the repute of norepinephrine and serotonin in the CNS

What kind of opioid analgesics treat pain?
opioid agonists and opioid agonist-antagonists

How do opioid antagonists work?
They bind primarily to mu opioid receptors to produce analgesic effects

How do opioid agonist-antagonists work?
They bind to mu and kappa receptors simultaneously stimulating and blocking their analgesic effects
– these are not as effective as opioid agonists

What is the prototype for opioid agonists?

What does morphine do?
It mimics the actions of naturally occurring opioids by binding with mu receptors to cause analgesia, sedation, euphoria, and respiratory depression

What are some adverse effects of morphine?
Respiratory depression, sedation, dizziness, lightheadedness, drowsiness, constipation, nausea, vomiting, ortho hypotension, urinary retention, cough suppression, potential for abuse and tolerance with continues use

What are some interventions that a nurse can do to help with the adverse effects of morphine?
Monitor vital signs, withhold drug if respirations fall below 12, monitor intake and output, increase fluid and fiber intake, take the drug with food or milk, report the inability to urinate

What do opioid agonist-antagonists do?
They provide analgesia for moderate to severe pain and act as an adjunct for anesthesia

What is the prototype for opioid agonist-antagonists?
Butorphanol and pentazocine (Talwin)

What are adverse effects for butorphanol?
limited respiratory depression, sedation, dizziness, lightheadedness, drowsiness, headache, nausea, increased cardiac workload, abstinence syndrome

What do opioid antagonists do?
they reverse opioid effects, overdose and the reversal of neonatal respiratory depression

What is the prototype for opioid antagonists?

What does Naloxone do?
It blocks opioid receptors, effectively reversing the effects of opioids

What are some adverse effects of Naloxone?
increased respiratory rate, blood pressure, heart rate and abstinence syndrome

What are some symptoms of abstinence syndrome?
Hypertensions, vomiting, tremors in opioid dependent patients

What is the prototype for uricosurics?
Allopurinol (Zyloprim)
other drugs: febuxostat and probenecid

How does allopurinol, febuxostat and probenecid work?
Allopurinol and febuxostat inhibit the enzyme Xanthin Oxidase (XO) from converting hypxanthin and xanthin into uric acid

Probenecid inhibits tubular reabsorption of uric acid thus promoting excretion of uric acid

What are some adverse effects of uricosurics?
Hypersensitivity, gastrointestinal disturbances, drowsiness, headache, vertigo, agranulocytosis, aplastic anemia, bone marrow depression, cataracts, metallic taste in mouth

When should caution be taken when administering uricosurics?
In those with bone marrow depression, liver or kidney dysfunction, peptic ulcer disease, and lower gastrointestinal tract disease

Glucocorticoid drugs are used in those with _______
inflammatory and autoimmune diseases

What are some uses of glucocorticoid drugs?
management of skin disorders, allergic reactions, delays progression of some disorders, prevents organ rejection and is an adjunctive therapy for some cancers

What is the prototype for glucocorticoids?
Prednidone (Deltasone)

How does prednidone work?
It suppresses the inflammation and immune response by inhibiting the synthesis of prostaglandins, decreases permeability of capillaries, inhibits lysosomal activity, and decreases production of lymphocytes

Types of Analgesics NSAID’s-interfere with prodiction of prostoglandins Opiods-stimulate opiod receptors Types of Anti-inflammatories Glucocorticoids Uricosurics WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample Drugs for pain Nonopioid analgesics …

Therapeutic Use (NSAIDS: COX-1 & COX-2 INHIBITORS) – aspirin, ibuprofen (Advil, Motrin) • Inflammation suppression • Analgesia for mild to moderate pain • Fever reduction • Dysmenorrhea • Inhibition of platelet aggregation (aspirin) Administration (NSAIDS: COX-1 & COX-2 INHIBITORS) • …

A health care professional is caring for a patient who is opioid-dependent and is about to begin taking butorphanol (stadol). The health care professional should recognize the patient is at risk for developing a sundrome that causes which of the …

Older adult patient about take prednisone for long-term treatment of rheumatoid arthritis. Monitor for what adverse effects? Bone loss prednisone (glucocorticoid) can cause osteoporosis esp with long-term use increase weight-bearing activity and report back pain. HCP must monitor bone density …

A health care professional should understand that naloxone can reverse the effects of an excessive dose of which of the following drugs? A) Aspirin B) Acetaminophen (Tylenol) C) Morphine D) Prednisone ANS: C Rationale: Naloxone, an opioid antagonist, reverses the …

Naloxone reversea excessive dosage of: Morphine Naloxone, an opioid antagonist, reverses the effects of morphine, an opioid analgesic. HCPs should monitor respirations and reassess pts after the effects of naloxone have diminished (20-40 minutes) for recurrence of the adverse effects …

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