Medications used for pain
The level of stimulus needed to produce the perception of pain
pain threshold
What are the IM sites?
Ventrogluteal
Vastus lateralis
deltoid
What is it called when a patient has a SBP of greater than 150 and a DBP greater than 90 and older than 60 years
hypertension
-pril
ACE inhibitor
What are antagonist drugs used for?
reverse adverse effects of a drug
-narcotic overdose
a powerful pain blocking chemical
endorphins
(enkephalins is a less powerful pain blocking chemical)
What are the SubQ sites?
- outer aspect of the upper arms
- anterior aspect of the thighs
- abdomen ( 2" from umbilicus)
- upper back beneath the scapula
- upper ventrogluteal & dorsogluteal areas
Leads to a decrease in heart rate and strengthing of contraction as well as vasodilatation
Beta-Blocker
-sartans
ARBs
Which vital sign is important to look at when giving opioids and when do you not give it?
Respirations under 12
What is the "5th Vital Sign"
Pain Assessment
What is the gauge size for ID injections?
What is the gauge size for subcutaneous injections?
What is the IM gauge size for adults?
26 - 27
25 - 30
18 - 23
Aldosterone releases from?
Renin releases from?
Angiotensin 1 is released from?
ACE is released from?
1) Aldosterone release from adrenals
2) Renin release from kidneys
3) Angiotensin 1 released from liver
4) Angiotensin converting enzyme released from lungs
5) ACE converts Angiotensin 1 into Angiotensin 2
6) Angiotensin 2 raises BP by connecting to smooth muscle and causing vasoconstriction
What drug is a Diuretic that works on the loop of Henle to increase urine production and Excretes more potassium
furosemide
What drug is 7x more potent than morphine
hydromorphone (dilaudid)
Sources of pain include Cutaneous, Somatic, Visceral, Phantom, neuropathic, vascular, referred, psychogenic. Where is cutaneous somatic and visceral pain felt?
Cutaneous- subcutaneous tissue, skin
Somatic- tendons, ligaments, bones, blood vessels, nerves
Visceral- internal organs
Why is IM absorbed more quickly than SQ?
- Greater blood supply to the muscles w/o discomfort than subcutaneous tissues
Relaxes muscle contraction or other autonomic blockers
Calcium Channel Blocker
Beta 1 receptors and Beta 2 receptors are responsible for what?
Beta 1 receptors responsible for heart muscle contraction
Beta 2 receptors responsible for smooth muscle contraction in the lungs
What are the 2 types of Non-opioid Analgesics?
Acetaminophen (APAP)
NSAIDS (non-steroidal anti-inflammatory drugs)
What does PQRST stand for and what does it mean?
•P: provokes/palliates (what causes the pain vs. what eases the pain, ex. rolling over hurt more).
•Q: quality (description) Sharp, dull, throbbing, heat, stabbing?
•R: region and radiation where is it located, does it move and radiate
•S: severity (use scales) Adults 0-10 scale
•T: timing of pain and last medication every 4 hours or prn meds.
IM: what are the 3 landmarks for ventrogluteal?
-greater trochanter
-anterior superior iliac spine
-iliac crest
Blocks the conversion of angiotensin I to angiotensin II; an angiotensin II receptor blocker; blocking effects of angiotensin on blood vessels
ACE/ARB: Inhibitor
What is the most commonly used diuretic for hypertension?
Thiazide
What do NSAIDS do?
What do non-selective NSAIDS block?
inhibit prostagladin or leukotrene pathways
BLOCK COX1 and COX2