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synthesis of prostaglandin in the CNS or of other substances that sentisize pain receptors to stimulation. The drug may relieve fever through central action in the hypothalamic heat-regulating center. Classification Therepeutic: antipyretics, nonopioid analgesics Contraindication -Contraindicated in patients hypersensitive to drug. -Use cautiously in patients wwith longterm alcohol use because therapeutic doses cause hepatotoxicity in these patients. Adverse Reaction -hemolytic anemia -leukopenia -neutropenia -pancytopenia -jaundice -hypoglycemia -rash -urticaria Nursing Consideration -Alert: Many OTC and prescription products contain acetaminophen; be aware of this when calculating total daily dose. -Use liquid form for children and patients who have difficulty swallowing. -In children, don't exceed five doses in 24 hours. -Assess overall health status and alcohol usage before administering acetaminophen.
Ketorolac
Action May inhibit prostaglandin synthesis, to produce antiinflammatory,anal gesic, and antipyretic effects.
Classification Therapeutic: nonsteroidal antiinflammatory agents, nonopioid analgesics Pharmacologic: pyrroziline carboxylic acid
Contraindication -Contraindicated in patients hypersensitive to drug and in those with active peptic ulcer disease, recent GI bleeding or perforation, advanced renal impairment, cerebrovascular bleeding, hemorrhagic diathesis, orv incomplete hemostasis, and those at risk for renal impairment from volume depletion or at risk of bleeding.
Adverse Reaction -headache -dizziness -drowsiness -sedation -arrhythmias -edema -hypertension -palpitations -dyspepsia -GI pain -nausea -constipation -diarrhea -flatulence -peptic ulceration -stomatitis -vomiting -pain at injection site
Nursing Consideration -Correct hypovolemia before giving. -Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions. Assess for rhinitis, asthma, and urticaria. -Pain: Assess pain(note type,location,and intensity) prior to and 1-2 hr following administration.
-Use cautiously in patients who are elderly or have hepatic or renal impairment or cardiac decompensation.
Nalbuphine Generic Name Brand Name Action Classification Contraindication Adverse Reaction Nursing Consideration
nalbuphine
Nubain
Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. In addition, has partial antagonist properties, which may result in opioid withdrawal in physically dependent patients.
- contraindicated in hypersensitivty to nalbuphine or Pharmacologic: bisulfites; Patients opioid who are physically agonists/analghes dependent on ics opioids and have not been detoxified(may percipate withdrawal) - use cautiuosly in head trauma; Increased intracranial pressure ; Severe renal, hepatic, or pulmonary disease; Hypothyroidism; Asrenal insufficiency; Alcoholism; Geriatric or debilitated patients(dose reduction suggested); Undiagnosed abdominal pain; Prostatic hyperplasia; Patients who have recently received
-dizziness -headache -sedation -confusion -floating feeling -hallucinations -blurred vision -diplopia -miosis -respiratory depression -hypertension -orthostatic hypotension -palpitations -dry mouth -nausea -vomiting -clammy feeling -sweating
-Assess type,location, and intensity of pain before and 1 hr after IM or 30 mins after Iv administration. -Assess blood pressure, pulse, and respirations before and periodically during administration. -Lab Test Considerations: May cause increase serum amylase and lipase concentrations.
opioid agonists.