Transcript Roach: Nonopioid Analgesics: Salicylates and Nonsalicylates

Introductory Clinical
Pharmacology
Chapter 17
Nonopioid Analgesics:
Salicylates and Nonsalicylates
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Pain Assessment
• Nursing role in providing Pain Management
– Need to take patient’s report of pain
seriously
– Understand patient’s pain level
– Teach patient to rate pain 0-10
– Fifth vital sign: Accurate assessment
necessary for effective pain management
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Drug Classification: Analgesics
• Definition: Drugs used to relieve pain
• Subcategories of Analgesics
– Salicylates (Aspirin)
– Non Opiods (Tylenol)
– Opiod Analgesics/Narcotics (Morphine)
– NSAIDs (Motrin)
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Salicylates
• Drugs derived from salicyclic acid
– Useful in pain management due to analgesic,
antipyretic, and anti-inflammatory effects
Medications to Recognize:
– aspirin “acetylsalicyclic acid” or “ASA”
– salsalate (Disalcid)
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Salicylates: Actions and Uses
• Lower body temperature
• Inhibit production of prostaglandins
(chemical that causes inflammation)
• Aspirin: prolongs bleeding time
• Used for: Mild to moderate pain; reducing
elevated body temperature; treating
inflammatory conditions; decreasing risk of
myocardial infarction; reducing risk of
transient ischemic attacks
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Salicylates: Adverse Reactions
• Gastrointestinal (GI) reactions
– Gastric upset; heartburn; nausea;
vomiting; anorexia; GI bleeding;
– Allergy to salicylates manifested by:
•Hives, rash, angioedema,
bronchospasm, anaphylactoid reactions
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Salicylates: Contraindications and
Precautions
• Contraindicated in clients with:
– Known hypersensitivity; bleeding
disorders; children with chickenpox or
influenza (risk for Reyes Syndrome)
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Nonsalicylates: Actions and Uses
• Actions
– Analgesic and antipyretic activity: Same as
salicylates
– No anti-inflammatory action
• Uses
– Used to treat mild to moderate pain; reduce
elevated body temperature; manage pain and
discomfort – arthritic disorders
• Medications to Recognize
– acetaminophen “APAP” (Tylenol)
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Nonsalicylates: Action and Uses
• Useful for people with aspirin allergy;
bleeding disorders; receiving anticoagulant
therapy; who had recent minor surgical
procedures
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Nonsalicylates: Adverse Reactions
• Adverse reactions: hepatotoxicity; hepatic
failure
• Overdose: Causes acute acetaminophen
poisoning or toxicity
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Nonsalicylates: Contraindications and
Precautions
• Contraindication in patients with
hypersensitivity
• Used cautiously in patients:
– With severe or recurrent pain or high or
continued fever
– Who are pregnant or lactating
(acetaminophen)
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Nursing Process: Assessment
• Preadministration assessment
– Assess: Type, onset, intensity, location of
pain
– Evaluate ability to carry out activities of
daily living
– Evaluate the response to previous drug
therapy
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Nursing Process: Implementation
•Check temperature before and 45-60
minutes after administration
•Suppository form of drug used: Check
after 30 minutes for retention of
suppository
•Notify PHCP if temperature not
controlled
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Nursing Process: Implementation
• Educating the patient and family
– Discontinue use 1 week before surgery or
dental procedure
– Teaching on acetaminophen includes:
•Acetaminophen lacks anti-inflammatory
properties of aspirin
•Notify primary health care provider if
any adverse reactions occur
•Avoid use of alcoholic beverages
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Nursing Process: Evaluation
• Relief from pain; body temperature normal
• Adverse reactions are identified, reported,
and managed
• Patient verbalizes the importance of
complying with the prescribed treatment
regimen
• Patient demonstrates understanding of
prescribed treatment regimen and adverse
effects
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End of Presentation
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