Pain and Inflammation Med Charts

Name Nonsteroidal Antinflammatory Drugs

Mechanism inhibition of cyclooxygenase, results in decrease in platelet aggregation,

of Action inflammation, fever, pain

Therapeutic inflammation, mild analgesia, fever, dysmenorrhea, inhibition of platelet

Uses aggregation (protection against stroke, MI)

Side Effects/ GI upset, damage to gastric mucosa, renal dysfunction, increased risk of
Precautions MI and stroke(for non ASA NSAIDS), Salicylism risk for ASA(tinnitus,
sweating, HA, respiratory aklaosis)

Interactions increased risk of bleeding with other anticoagulants, glucocorticoids,

alcohol. Ibuprofen decreases antiplatelet effects of ASA

Nursing/Pati take NSAIDS with food to decrease gastric discomfort, notify provider if
ent teaching symptoms of salicylism occurs, concurrent use with opioids allow for lower
dosages of opioids

Common ASA, Ibuprofen, Naproxen, Indomethacin (Indocin), Ketorolac (Toradol),

Drugs Meloxicam (Mobic), Colecoxib (Celebrex)

Name Acetaminophen

Mechanism slows production of protaglandins in CNS

of Action

Therapeutic analgesic, antipyretic

Uses

Side Effects/ acute toxicity results in liver damage (early symptoms include nausea,
Precautions vomiting, diarrhea, sweating, abdominal discomfort)

Interactions alcohol increases risk of liver damage, slows metabolism of warfarin

Nursing/Pati do not exceed 4 mg/ day, acetylcysteine (Mucomyst) is antidote for

ent teaching overdose

Common tylenol
Drugs

Name Opioid Agonist

Mechanism act on mu and kappa receptors, produces analgesia, respiratory

of Action depression, euphoria, sedation, decreased GI motility

Therapeutic moderate to severe pain

Uses

Side Effects/ respiratory depression, constipation, orthostatic hypotension, urinary

Precautions retention, cough suppression, sedation, emesis
Interactions CNS depressants have additive depression action. Anticholinergics,
antihistamines, tricyclic antidepressants have additive anticholinergic
effects. MAOIs may cause hyperpyrexic coma.

Nursing/Pati overdose triad: coma, repiratory depression, pinpoint pupils. Administer

ent teaching very slowly, over 4 to 5 minutes. Narcan is antidote. Do not administer
more than 600 mg/24 hour period for meperidine (Demerol).

Common morphine, Fentanyl (Sublimaze, Duragesic), Meperidine (Demoerol),

Drugs Methadone (Dolophine), Codeine/oxycodone (OxyContin)

Name Agonist - antagonist opioids

Mechanism antagonists act on mu and kappa receptors, lower potential for abuse, less
of Action respiratory depression, and less analgesic effect compared to pure opioid
agonists

Therapeutic moderate to sever pain, treament of opioid dependence, adjunct to

Uses balanced anesthesia,,

Side Effects/ sedation, respiratory depression, dizziness, increased intracranial

Precautions pressure, HA, increased cardiac workload. abstinence syndrome (for those
who are dependant on opioids)

Interactions additive CNS depression with other CNS depressants, opioid agonists may
antagonize and reduce analgesic effects (do not use concurrently)

Nursing/Pati caution when undisclosed opioid use is suspected. Again, opioid agonist
ent teaching and opioid agonist antagonist should not be used together. Naloxone
(narcan) is antidote

Common butorphanol (Stadol), hydrochloride (Nubain), Buprenorphine

Drugs hydrochloride (Buprenex)

Adjuvant Medications for Pain: used with a primary pain medication,

usually an opioid agonist in order to reduce opioid dosage to reduce side
effects.

NSAIDS treats inflammation.

side effects: bone marrow suppresion, GI distress

Tricyclic treats depression, neuropathic pain such as cramping/aching/burning.

antidepress (amitriptyline (Elavil))
ants side effects: orthostatic hypotension, sedation, anticholinergic effects

Anticonvuls neuropathic pain (carbamazepine (Tegretol), gabapentin (Neurontin))

ants side effects: bone marrow suprresion, GI distress

CNS analgesia, decrease sedation. (methylphenidate (Ritalin))

stimulants side effects: weight loss, insomnia

Antihistami decrease anxiety, prevent insomnia and relieve nausea (hydroxyzine

nes (Vistaril))
Bisphospho manage hypercalcemia and bone pain (etidronate (Didronel))
nates side effects: flu like symptoms, venous irritation, renal failure

glucocortico decrease pain from intracranial pressure and spinal cord compression.
ids (dexamethason (Didronel))
side effects: adrenal insufficiency, osteoporosis, hypokalemia, glucose
intolerance, peptic ulcer disease

Name Migraine Meds

Mechanism prevent inflammation and dilation of the intracranial blood vessels,

of Action relieving migraine pain

Therapeutic stopping acute migraine attacks, prevention of chronic migrains

Uses

Side Effects/ depends on type (pg 473)

Precautions

Interactions depends on type

Nursing/Pati avoid trigger factors that cause stress (alcohol, fatigue, tyramine
ent teaching containing foods (aged cheese))

Common Ergot alkaloids: ergotamine (Ergostat)

Drugs Serotonin receptor agonist: sumatriptan (Imitrex)
Beta Blockers: propranolol (Inderal)
Anticonvulsants: divalproex (Depakote)
Tricyclic antidepressants: anitriptyline (Elavil)
Calcium channel blockers: verapamil (Calan)
Estrogens: Estraderm
Ergot alkaloids: Cafergot

Name Local Anesthetics

Mechanism decrease pain by blocking conduction of pain impulses in a specific area

of Action

Therapeutic dental procedures, minor surgical procedures, labor and delivery, regional
Uses anesthesia, skin and mucous membrane disorders, minor procedures (IV
insertion, injection, wart removal)

Side Effects/ CNS excitation (seizures, followed by respiratory depression, leading to

Precautions unconsciousness), hypotension, can prolong labor

Interactions additive hypotensive effects with parenteral administration

Nursing/ vasoconstrictors (epinephrine) often used in combination with local

Patient anesthetic to stop the spread. topical cream applied one hour before
teaching procedure.

Common lidocaine (Xylocaine), tetracain (Pontocaine), procain (Novocain)

Drugs