ANALGESICS

Non-Opiod Analgesics

NON-OPIOD
ANALGESICS

COMMON USES

WHAT I NEED TO KNOW AS A BRAND NEW

NURSE

Acetominophen (Tylenol)

*Antifever DOC for children

and adolescents due to the
risk of Reyes Syndrome
with aspirin products.
* Indicated for the treatment
of mild to moderate pain, or
fever. Minimal to no antiinflammatory effects.
*Primary alternative to
NSAIDs

* Hepatotoxic in large doses, contraindicated with known liver

disease or in patients who consume alcohol on a regular basis
*Acetominophen inhibits Warfarin metabolism, which can cause
Warfarin to accumulate to toxic levels.
*With long-term use monitor hepatic function tests, ALT, AST, and
bilirubin
*Treat overdose with IV or oral N-acetylcysteine (Acetadote)

Indicated for the treatment of

mild to moderate pain,
especially pain associated
with inflammation.
*Antipyretic
*Anticoagulant, indicated to
reduce the risk of MI, strokes
and colorectal cancer

*Most serious adverse effect is GI complaints including GI bleeding.

*Available in enteric-coated and buffered preparations for patients
who experience GI effects.
*Discontinue 1 week prior to surgery due to its anticoagulant effects
*Excreted in urine, may affect urine testing for glucose and
vanillylmandelic acid (VMA)
* Aspirin contraindicated in children and adolescents due to the risk
of Reyes Syndrome.
* Contraindicated with vitamin K deficiency and peptic ulcer disease.

Therapuetic class:
Analgesic, antipyretic

Aspirin (ASA,
Acetylsalicylic Acid)
Therapuetic Class:
Analgesic, NSAID,
antipyretic

NSAIDS
Common NSAIDS: Ibuprofen
(Advil, Motrin), Naproxen sodium
(Anaprox, Aleve), Meloxicam
(Mobic), ketorolac tromethamine
(Toradol)

*DOC for the treatment of

mild to moderate pain,
especially pain associated
with inflammation.
*Antipyretic
*Certain types of arthritis

* Most serious adverse effect is GI complaints including GI bleeding.

* Take with food or milk to decrease GI upset
* Contraindicated with peptic ulcer disease.
*Monitor renal function and urine output with long-term use
*Use with caution in patients with history of heart failure,
hypertension or MI

*Acute pain, especially

associated with multiple
types of arthritis

* Most serious adverse effect is GI complaints and headache

*May increase the risk of serious thrombotic events, MI, or stroke
*May cause fluid retention
*Associated with hepatotoxicity with long-term use

Therapuetic Class:
Analgesic, NSAID,
antipyretic
NSAIDS: COX 2-Inhibitors
Celecoxib (Celebrex)
Therapuetic Class:
NSAID, Analgesic

ANALGESICS
Opiod Analgesics
OPIOD
ANALGESICS

COMMON USES

WHAT I NEED TO KNOW AS A BRAND NEW

NURSE

Tramadol (Ultram)

*Indicated for the treatment of moderate

to severe pain and chronic pain.

* Adverse effects include drowsiness, dizziness, HA, nausea

and vomiting, constipation.
* Seizures have been reported in patients taking Tramadol.

Hydromorphone
hydrochloride
(Dilaudid)

*Moderate to severe pain

*Moderate to severe pain requiring
continuous analgesia for an extended
period of time (new indication)

*Tablet form available in extended-release, do not crush or

break
*Most serious adverse effects: Respiratory depression and
bradycardia
*May cause constipation
*Commonly abused opiod
* Overdose treatment Naloxone (Narcan

Morphine Sulfate
(Duramorph, MS
Contin, DepoDur)

*Indicated for symptomatic relief of

moderate to severe pain
*DOC for MI pain because it decreases
the workload of the heart.
*Preanesthetic
*Epidural single-dose for extended pain
relief

*Most serious adverse effect: Respiratory depression,

overdose can cause respiratory arrest.
*Causes peripheral vasodilation which may result in
orthostatic hypotension
*May cause constipation, commonly severe with maintenance
dose
*Contraindicated in patients with GI obstruction, may mask
gallbladder pain
*Commonly abused opiod
* Overdose treatment Naloxone (Narcan)

Therapuetic Class:
Opiod analgesic. Does
not have abuse potential
and is not a scheduled
drug

Merperidine (Demerol)

Fentanyl (Duragesic,
Sublimaze)

Codeine

Other Opiod
Analgesics:
Common examples: Vicodin,
Lortab, Percodan, Percocet,
Oxycontin

*Indicated for moderate to severe pain

* Pre-op sedation, adjunct to anesthesia.
*Preferrred obstetric analgesic because
it does not delay uterine contractions and
causes less neonatal respiratory
depression than other opiod narcotics.
*Moderate to severe pain associated with
pancreatitis
*Option for patients allergic to Morphine
*Short-acting analgesic indicated for
moderate to severe pain and sedation.
*Often used during operative and perioperative periods.
*Adjunct to regional and general
anesthesis
*Management of moderate to severe
chronic pain in patients who require
around-the-clock opiod analgesics
*Management of breakthrough pain
associated with cancer
*Indicated for mild to moderate pain
*Frequently used antitussive and cough
suppressant.

Indicated for mild to moderate pain.

* Adverse effects include drowsiness, dizziness, respiratory

depression, constipation, nausea and vomiting.
*Use with caution in elderly patients and patients with
debilitating diseases.
*Avoid in patients with hepatic or renal disease
* Overdose treatment Naloxone (Narcan)

* Available in patch form for chronic severe pain.

* Adverse effects include: constipation, dizziness, euphoria,
hypotension, bradycardia, respiratory depression, circulatory
depression and cardiac arrest.
* Overdose treatment Naloxone (Narcan)

* Less analgesic and respiratory effects than other opiod

narcotics..
*Dose needed to suppress cough is low with minimal
potential for abuse
* Adverse effects include: dizziness, euphoria, drowsiness,
constipation, hypotension, bradycardia and pruritis
* Combination drugs combined with aspirin, acetominophen
or an NSAID.
* Adverse effects similar to those seen with Codeine and nonopiod analgesics.
*Constipation
*Monitor for hepatotoxicity in long-term use of
acetaminophen combination forms