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vo adams_ch29_lecture

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Education

Published on March 12, 2014

Author: ritapeters

Source: authorstream.com

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PowerPoint Presentation: Pharmacotherapy of Severe Pain and Migraines 29 Learning Outcomes: Learning Outcomes Describe the role of nonpharmacologic therapies in pain management. Describe the nursing assessment of pain. Identify the classes of drugs used for minor, moderate, and severe pain. Compare and contrast the actions of opioid agonists, mixed opioid agonists-antagonists, and opioid antagonists. Describe the advantages of combining opioid, nonopioid , and adjuvant analgesics in the treatment of pain. Learning Outcomes: Learning Outcomes 6. Compare and contrast the actions and adverse effects of opioids and nonopioids for analgesia. 7. For each of the classes shown in the chapter outline, identify the prototype and representative drugs and explain the mechanism(s) of drug action, primary indications, contraindications, significant drug interactions, pregnancy category, and important adverse effects . 8. Explain the role of opioid antagonists in the diagnosis and treatment of acute opioid toxicity. 9. Compare the types of drugs used for preventing migraines to those for terminating migraines. 10. Apply the nursing process to care for patients receiving drug therapy for pain. General Principles of Pain Management: 29.3 Health care providers and patients sometimes hold myths about pain that impede optimum pain management. General Principles of Pain Management General Principles of Pain Management: 29.5 Nonpharmacologic interventions are utilized to reduce and augment analgesic use. General Principles of Pain Management General Principles of Pain Management: 29.6 The overall goal of pain management is to maintain a patient pain level that allows self-care and activities of daily living. General Principles of Pain Management Classes of Drugs for Pain: Classes of Drugs for Pain Nonopioids NSAIDs, centrally acting agents, or acetaminophen Used for mild to moderate pain Opioid drugs Used to treat severe pain Adjuvant analgesics Used to treat chronic pain that is neuropathic in nature Pharmacotherapy of Acute and Chronic Pain: 29.8 Opioids are the drugs of choice for moderate to severe pain that cannot be controlled with other classes of analgesics. Pharmacotherapy of Acute and Chronic Pain Actions and Side Effects of opiods: Actions and Side Effects of opiods Actions and side effects of nonopiods: Actions and side effects of nonopiods Prototype Drug: Morphine Sulfate (Astramorph PF, Duramorph RF, Roxanol, Others): Prototype Drug: Morphine Sulfate (Astramorph PF, Duramorph RF, Roxanol, Others) Therapeutic classification Pharmacologic classification Pregnancy category Mechanism of action Indications Contraindications Precautions Drug interactions Adverse effects Prototype Drug: Morphine Sulfate (Astramorph PF, Duramorph RF, Roxanol, Others): Prototype Drug: Morphine Sulfate (Astramorph PF, Duramorph RF, Roxanol, Others) Nursing responsibilities Similar Drugs to Morphine Sulfate : Similar Drugs to Morphine Sulfate Codeine Fentanyl (Abstral, Actiq, Duragesic, Fentora, Onsolis, Sublimaze) Hydrocodone ( Hycodan , others) Hydromorphone ( Dilaudid , Exalgo ) Levorphanol ( Levo-Dromoran ) Meperidine (Demerol) Methadone ( Dolophine ) Oxycodone ( OxyContin , others) Pharmacotherapy of Acute and Chronic Pain: 29.9 Mixed agonist and antagonist opioids exhibit moderate analgesia with less risk of dependence than morphine. Pharmacotherapy of Acute and Chronic Pain Mixed Agonist-Antagonist Opioids: Mixed Agonist-Antagonist Opioids Buprenorphine ( Buprenex , Butrans , Suboxone , Subutex ) Butorphanol ( Stadol ) Nalbuphine ( Nubain ) Pentazocine ( Talwin ) Pharmacotherapy of Acute and Chronic Pain: 29.10 Nonsteroidal anti-inflammatory drugs are the medications of choice for mild to moderate pain. Pharmacotherapy of Acute and Chronic Pain Pharmacotherapy of Acute and Chronic Pain: 29.11 A few miscellaneous analgesics reduce pain by acting on the central nervous system. Pharmacotherapy of Acute and Chronic Pain Prototype Drug: Tramadol (Ultram): Prototype Drug: Tramadol (Ultram) Therapeutic classification Pharmacologic classification Pregnancy category Mechanism of action Indications Contraindications Precautions Drug interactions Adverse effects Prototype Drug: Tramadol (Ultram): Prototype Drug: Tramadol (Ultram) Nursing responsibilities Similar Drugs to Tramadol: Similar Drugs to Tramadol Clonidine ( Catapres , Duraclon ) Ziconotide ( Prialt ) Pharmacotherapy of Acute and Chronic Pain: 29.12 Adjuvant analgesics have primary indications other than pain but can enhance analgesia. Pharmacotherapy of Acute and Chronic Pain Types of Adjuvant Analgesics: Types of Adjuvant Analgesics Antidepressants Antiseizure drugs Corticosteroids Local anesthetics Muscle relaxants Bone-specific agents Miscellaneous agents Pharmacotherapy with Opioid Antagonists: 29.13 The primary indication for an opioid antagonist is opioid-induced respiratory depression. Pharmacotherapy with Opioid Antagonists Prototype Drug: Naloxone (Narcan): Prototype Drug: Naloxone ( Narcan ) Therapeutic classification Pharmacologic classification Pregnancy category Mechanism of action Indications Contraindications Precautions Drug interactions Adverse effects Prototype Drug: Naloxone (Narcan): Prototype Drug: Naloxone ( Narcan ) Nursing responsibilities Similar Drugs to Naloxone: Similar Drugs to Naloxone Nalmefene ( Revex ) Naltrexone ( Depade , Embeda , ReVia , Vivitrol ) Pharmacotherapy of Migraines: 29.14 Migraines are a severe type of headache related to specific triggers. Pharmacotherapy of Migraines Migraine Pharmacotherapy: Migraine Pharmacotherapy Mild migraine Moderate Severe Pharmacotherapy of Migraines: 29.15 Analgesics and triptans are the primary classes of drugs used to abort acute migraine pain. Pharmacotherapy of Migraines Prototype Drug: Sumatriptan (Imitrex): Prototype Drug: Sumatriptan ( Imitrex ) Therapeutic classification Pharmacologic classification Pregnancy category Mechanism of action Indications Contraindications Precautions Drug interactions Adverse effects Prototype Drug: Sumatriptan (Imitrex): Prototype Drug: Sumatriptan ( Imitrex ) Nursing responsibilities Similar Drugs to Sumatriptan: Similar Drugs to Sumatriptan Almotriptan (Axert) Eletriptan (Relpax) Frovatriptan (Frova) Naratriptan (Amerge) Rizatriptan (Maxalt) Zolmitriptan (Zomig) Pharmacotherapy of Migraines: 29.16 Many drug therapies are used for migraine prophylaxis. Pharmacotherapy of Migraines

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