Pharmfr7

• Calcitonin Gene-Related Peptide (CGRP) receptor antagonist

  
• Serotonin 5-HT Receptor Agonists

  
• Salicylates


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• Opioid Antagonist

  
• Opioid Agonist-Antagonist

  
• Opioid Agonist

  
• Opioid Agonist

  
• Centrally acting non-opioid

  
• nonsalicylate analgesic


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• COX2 Inhibitors


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• Cox1 and COX 2 inhibitors


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• Acute pain has a short duration of less than 3 to 6 months
• Chronic pain lasts more than 6 months
• The antipyretic effect of salicylates is caused by the lowering of body temperature by the dilation of peripheral blood vessels
• Salicylates 


  Analgesic and anti-inflammatory—inhibit the production of prostaglandins
• Aspirin prolongs bleeding time by inhibiting the aggregation of platelets
• Salicylates—Adverse


  GI bleeding
• Aspirin Toxicity


  dizziness; tinnitus, nausea; vomiting; rapid, deep breathing; tachycardia; diarrhea; mental confusion; and coma
• in children or teenagers who have influenza or chickenpox (Reye syndrome)
• tylenol/ nonsalicylates

  • Analgesic and antipyretic activity: same as salicylates 

  •No anti-inflammatory action 

  •Nonopioid drug—mechanism of action unknown
• Monitor blood glucose levels in diabetic pts taking acetaminophen
• Nonsalicylates—Adverse

  • Skin eruptions, urticaria
  • Hypoglycemia
  • Jaundice, hepatotoxicity, and hepatic failure
• habitual alcohol use – a person who drinks alcohol consistently should take no more than 2000 mg of acetaminophen a day
• Acute overdosage of acetaminophen treated with gastric lavage within 4 hours of ingestion and acetylcysteine via nebulizer within 24 hours to prevent liver damage
• Document description of pain and an estimate of when the pain began
• NSAIDs inhibit the activity of two cyclooxygenase enzymes:

  • COX1
  • COX2
• cyclooxygenase-1 (COX-1): Enzyme helps to maintain the stomach lining
• cyclooxygenase-2 (COX-2): Enzyme triggers pain and inflammation
• Celecoxib: specifically inhibits only COX-2; less potential for GI adverse reactions
• All NSAIDs may increase risk of serious cardiovascular thrombosis, myocardial infarction, and stroke, which can be fatal
• NSAIDS

  Notify provider for the following symptoms:

  •Chest pain

  •Visual disturbances

  •Skin rash
• NSAIDS


  flushing,sweating
• Ubrogepant


  block nociception so nerves are not stimulated, and pains and vasodilation do not occur
• Activation of the serotonin 5-HT receptors causes vasoconstriction and reduces the neurotransmission, which in turn produces pain relief
• NSAID administered with food, milk, or antacids
• The “pain ladder” directs the use of both opioids and nonopioids in the treatment of mild to severe pain
• Butorphanol


  Binds to the mu receptor as an antagonist and the kappa receptor as an agonist
• tramadol


  Binds to the opioid receptor to block the reuptake of serotonin and norepinephrine.
• morphine


  Bind to the with the Mu receptors to cause analgesia, sedation, euphoria and respiratory depression, weakness, headache
• Opioid Analgesics AR

  • Depression of rate and depth of breathing

  •Coach the client to breathe if respirations are depressed