A/S - Pharmacologic Analgesia
Terms
undefined, object
copy deck
- A/S - Pharamcologic Analgesia
- A/S - pharmacologic Analgesia
- What is preemptive use?
- Administering drugs before or during surgery
- If it is not possible to administer drugs before or during surg, when should they be administered?
- Before pt wakes up
- What are three methods for administering pharmacologic analgesia?
- anagesic used as preanesthetic, epidural, local/regional nerve block
- What is windup?
- build up of chemical mediators in spinal cord that intensify the perception of pain
- What is the mechanism of action for pharmacologic analgesia?
- prevents windup
- Does preemptive analgesia remove the need for addtl post op pain control?
- No
- NSAIDs work at the ___ level
- tissue, some have direct effect in brain
- What analgesics block xmission of pain impulses in sensory nerves?
- local anesthetics
- What analgesics affect sites in brain and spinal cord to decrease perception of pain?
- Opioids
- What is the term for using drugs from more than one class of analgesic to give more effective pain relief, decr amt of each drug, and decr side effects?
- Balancedor multimodal analgesia
- What are three classes of pharacologic analgesics?
- Opioids, NSAIDs, Local anesthetics
- What class of pharmacologic analgesic is used as a preanesthetic, produces neuroleptanalgesia, and postoperative pain control
- opioids
- What opioid is both an agonist and an antagonist?
- Butorphanol
- What are some off label routes of admin for opioids? Why used?
- IV infusion, epidurals, dermal patches, intra-articular - longer duration than IM or SC, less potential for side effects
- What drug reverses opioids?
- Nalaxone
- All NSAIDs are effective analgesics for ___ pain
- somatic
- Older NSAIDs are not effective for ___ pain
- analgesic
- All NSAIDs req ___ minutes to take effect
- 30-60
- All NSAIDs have significant side effects which may increase surgical risks - name them (3)
- decr platelet aggregation, decr renal blood flow, metabolized by liver and excreted by kidney or bile
- Should NSAIDs be used preemptively?
- Better not to - if you have to, give IV fluids
- NSAIDs can cause ulcers - given this, what precautions should be taken?
- Use carprofen, etodolac, or meloxicam (less ulcerogenic), give w/ meal, use GI protectants such as sucralfate
- What are some advantages of NSAIDs over opoids?
- oral, not controlled, littel resp/cardiac effect, no sedative effect (for postoperative use)
- What are some contraindications for NSAIDs?
- Tylenol in cats (use ketoprofen), dehydrated/hypotensive pt. liver or kidney dysfunction, corticosteroids, GI disorders, CHF, clotting disorders
- What class of pharmacologic analgesics are used pre-emptively only?
- local anesthetics