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PHTH 564 > Medications > Flashcards

Medications Flashcards

1
Q

4 main categories of medication

A
  1. Analgesics
  2. Sedatives + Paralytics
  3. Vasopressors and inotropes
  4. Anticoagulants
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2
Q

3 sources of sub-optimal pain management

A
  • inadequate
  • Excessive
  • not on schedule
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3
Q

Effect of sup-optimal pain management

A
  • Delayed mobilization
  • inability to wean from ventilator
  • Poor respiratory state
  • +/- use of reversal drugs
  • Delirium

Leading to prolonged stay in ICU

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4
Q

4 ways to optimize analgesia

A
  • Follow an interdisceplinary, structured approach to analgesia
  • Use a patient-specific validated pain scale
  • address underlying source of pain
  • Minimiza and be aware of adverse effects
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5
Q

Facial signs of underlying pain

A
  • Brow lower
  • Lid tighten
  • Eye closure
  • Cheek raise
  • nose wrinkle
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6
Q

Facial signs of transient pain

A
  • Brow lower
  • Lid tighten
  • Eye closure
  • Cheek raise
  • nose wrinkle
  • lip raise
  • mouth open
    Jaw drop
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7
Q

3 pain assessment tools

A
  • Behavioral pain scale
  • Critical care pain observation tool
  • Wong-Baker FACES pain rating scale
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8
Q

What is the difference between analgesia and anesthetic

A

Analgesia - pain relief

Anesthetic - blocking sensation including pain

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9
Q

What are types of analgesia

A

Opiates

NSAIDS

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10
Q

What are types are anesthetic

A

General anesthetic
Nerve blocks
Numbing agents

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11
Q

What are 3 levels of the nervous system analgesias can effect

A
  • CNS (brain)
  • Spinal level
  • Peripheral nerve root
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12
Q

At what level does acetaminophen work?

A

CNS (brain)

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13
Q

At what level do NSAIDS work

A

Peripheral nerve root

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14
Q

At what level do opioids work

A
  • CNS (brain)

- Spinal level

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15
Q

How do opioids work

A
  • bind to opioid receptors (brain, spinal cord, other organs) and block pain signals sent from brain to the body and release large amounts of dopamine
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16
Q

3 non-opioid drugs used in ICU

A
  • Acetaminophen
  • NSAIDS
  • Gabepentic or pregabalin
17
Q

Whic of the non-opioid drugs used in ICU is the quickest acting? Which lasts the longer?

A

Acetaminophen and NSAIDS both 30mins to 1hour

Gabapentin and pregabalin

18
Q

Precautions with acetaminophen

A

Caution with liver failure/alcoholism

19
Q

Precautions with NSAIDS

A

Long term use can increase GI/renal/bleeding complications

20
Q

Precautions with Gabapentin or pregabalin

A
  • Can sedate

- Monitoring with renal dysfunction

21
Q

Which non-opioid drugs used in ICU is used for neuropathic pain

A

Gabapentin or pregabalin

22
Q

Opioids supress drive to ___

A

breath

23
Q

3 opioids used in ICU

A

Morphine
Hydromorphone
Fentanyl

24
Q

Which of the 3 opioids used in ICU is the strongest?

A

Fentanyl 100x stronger than morphine (hydromorphone 10x stronger than morphine

25
Q

Precaution with morphine

A

Drug accumulates in renal failure - itchy skin

26
Q

Which what populations is hydromorphone preferred

A

Elderly and renal dysfunction

27
Q

What type of pain in fentanyl good for

A

procedural pain

28
Q

Opioid side effect in CNS

A

Decreased LOC, delirium

29
Q

Opioid side effect in Resp

A

Depression (decreased drive to breath, decreased RR)

30
Q

Opioid side effect in CVS

A

Decreased BP/MAP/HR

31
Q

Opioid side effect in GI

A

Decreased gut motility, nausea

32
Q

Opioid side effect in DERM

A

rashes

33
Q

What are anti-emetics

A

Drugs taken alongside opioids to try and manage nausea

34
Q

3 common anti-emetics

A
  • Dimenhydrinate (Gravol)
  • Ondansetron
  • Dexamethasone
35
Q

Physiotherapy implications of analgesics

A
  • Consider timing of analgesia with active treatment for optimal pain control
  • Look for trends in analgesia needs with care/movement
  • Be alert for respiratory side effects
  • be aware of how our interventions can increase or prevent pain and always consider what we can offer for pain control
36
Q

What are predisposing factors that may be reason to sedate/paralyze a patient

A
  • Anxiety
  • Sleep disorders
  • Prior substance abuse
  • medical conditions

PHTH 564 (5 decks)

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