1/26/2022 PAIN NUR 106 INFLAMMATION & FEVER Learning Outcomes • Know the drug classes, mechanism of action, side effects, and important adverse events for opioid and nonopioid analgesics. • Explain the general strategies for treating pain and inflammation. • Know the classes of drugs known as antiinflammatories, corticosteroids, and antipyretic medications, their actions and side effects. 1 1/26/2022 PAIN Defined: “Pain is an unpleasant sensory and emotional experience that is usually associated with trauma or disease.” Pain is always SUBJECTIVE… Nonpharmacologic al Pain Treatment • • • • • • • • Acupuncture Massage Heat or Cold packs Meditation/Prayer Relaxation Art/Music therapy Physical therapy Nerve Stimulator (TENS) 2 1/26/2022 PAIN MECHANISM Pain signals begin at “nociceptors”- nerve endings located within body tissues then proceed to the CNS. *Target Areas * – Peripheral level (NSAIDS) – CNS Level (Opioids) THE SCIENCE OF OPIOIDS 3 1/26/2022 First line drug for severe or extreme pain Natural or Synthetic Substances Inhibit pain: Brain, Spinal Cord, & Periphery OPIOID ANALGESICS “Droopy Drawers” Depressed Resp Decreased B/P Constipation Urinary Retention Blurred Vision Dependence Opioid Side Effects 4 1/26/2022 NURSING CONSIDERATIONS Assess Assess respiratory status Assess Assess for changes in LOC Assess Assess potential for opioid dependency Monitor Monitor urine output for retention Monitor Monitor bowel habits for constipation OPIOID ANTAGONIST 5 1/26/2022 Emergency Overdose Treatment Naloxone (Narcan) Side Effects “PERKY” Pants = INCREASED Perspiration Pulse Pressure Pain Puke 6 1/26/2022 NONOPIOID ANALGESICS reduces fever mild to mod. pain Analgesic Treatment of Mild to Moderate Pain Reduce fever and inflammation Acetaminophen 7 1/26/2022 N- Acetylcysteine Acetaminophen “Antidote” Non-Opioid Considerations N= No Alcohol S = Salt and fluid retention A = Acute kidney failure I = Inhibits prostaglandins D = Do take with food S = Stop 1 week prior to surgery 8 1/26/2022 Special Cases: (other than relieving pain/inflammation) ASPIRIN Side Effects Prophylaxis for CV events… Chest pains? Chew one Stomach irritation N/V Bleeding Non-Opioid vs. Opioid Agonists Ketorolac - Toradol 9