Ergotamine (Cafergot)
Dosage
What is: (sometimes includes caffeine)- 1-2mg inital dose followed by 1 additional mg every 30 minutes until symptoms decrease. Max dose =6mg per attack (10 mg per week) Can be given IM and IV
Dosage
What is: Can be administeredd parenteral, regional, or topical. Dosage will vary depending on route
Treatment Examplars:
What is:- Acetamin/NSAID compo- reduce pain and inflammation
-Ergot alkaloids: ergotamine- used to treat severe throbbing headaches, will not help any other type of pain
-triptans: sumatriptan
Tricyclic antidepressants
What is: amitriptyline- helpful for neuropathic (nerve pain)
Symptoms of Opioid Withdrawal
What is: anxiety, IRRITABILITY, CHILLS, and hot flashes, joint pain, lacrimation, rhinorrhea, diaphoresis, nausea, vomiting, ABDOMINAL CRAMPS, DIARRHEA, confusion
What is: Ergot alkaloid- serotonin 5 HT receptor agonist and dopamine/alpha adrenergic partial agonist. Causes vasoconstriction of peripheral and cranial vessels.
Therapeutic=antimigraine
Class of this medication
What is: Amide- blocks pain by blocking influx of NA+ ions into the membrane surrounding nerves in a specific area.
Therapeutic=local anesthetic
What is: propranolol- used to PREVENT migraines, prevents dialtion of vessels in the brain
CNS stimulants and Antihistamines
What is: CNS Stimulants: methylphenidate-helpful to decrease sedation effects of pain medications
Antihistamine: hydroxyzine-helpful to relieve nausea and vomiting from opioid analgesia or anesthesia
Opioid Physical Dependency
What is: habitual use of a drug that results in WITHDRAWS S/S with abrupt d/c
Why is my patient taking this medication?
What is: Migraine headache treatment
Why is my patient taking this medication
What is: Pain management for dental procedures, minor surgeries, labor and delivery, and diagnostic procedures. Also used with spinal or epidural anesthesia.
Migrain prevention with Anticonvulsants
What is:divolproex- increases GABA to suppress migraine related incidents
Glucocorticoids
What is: dexamethasone- steroid anti inflammatory. Decreases intracranial pressure pain, spinal cord compression pain ad any inflammatory pain process such as arthritis.
Opioid Addiction
What is: a COMPULSIVE CRAVING for a drug motivated by the feelings the drug provides rather than the body's need for the drug and negatively alters the patients life
What is: Nausea/vomiting, muscle pain, paresthesia, peripheral ischemia, hypertension
Major side effects
What is: cardiac arrhythmias, seizure activity, and respiratory depression
What is: amitriptyline- increases serotonin and changes the way nerve signals receive pain.
Bisphosphonates
What is: Etidronate-helps with bone pain from osteoporosis
Opioid Tolerance
What is: A common physiologic result of chronic or long term opioid treatment.
Result: larger dose is required to maintain the same level of pain relief
Tolerance and dependence are expected with long-term opioid use
Special Nursing Considerations
What is: -Teratogenous- should use contraception( can cause uterine contraction, used for postpartum hemorrhage
-Current/History of MI (CAD), stroke, or peripheral vascular syndrome should not use.
-Caution with hepatic impairment
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Special Nursing Considerations
What is: monitor vital signs (especially hearth rhythm and respiratory status) and monitor for local reaction with topical forms
Migraine Prevention with Estrogens
What is: estrogen- steady estrogen levels decrease incidence of migraines in women
NSAIDS and Anticonvulsants
Anticonvulsants: gabapentin
Apioid abstinence syndrome (opioid withdrawal)
What is: can occur in as little time as 2 weeks of opioid therapy and is a sign of physical dependence