PAIN MANAGEMENT
Opioid Analgesics
Definition: These medications control pain by blocking pain receptors in the brain.
Types: Morphine sulfate, fentanyl, meperidine (Demerol), hydromorphone (Dilaudid), oxycodone/acetaminophen (Percocet), oxycodone (Oxycontin), codeine, and tramadol (Ultram).
Contraindications: Obtain an allergy history before administering. Patients with depressed respirations and bradycardia should use caution when taking these medications. Use with caution in patients who are sedated or drowsy.
Pharmacokinetics: Given PO or IV. Metabolized by the liver and excreted through the urine.
Side Effects: Drowsiness, nausea, vomiting, hypotension, urinary retention, constipation, respiratory depression, and impaired vision.
Nursing Care: Teach the patient about the side effects of the medications. Monitor the patient’s mental status. Narcan can be given if the patient is overmedicated. Monitor vital signs. Advise patients to avoid alcohol while taking these medications. Opioids can also be given through a patient-controlled analgesic device. To decrease constipation, use stool softeners daily. Encourage patients to take these medications with food to avoid GI upset.
Nonopioid Analgesics
Definition: These medications have anti-inflammatory, antipyretic, and pain-relieving effects.
Types: Acetaminophen (Tylenol) and ibuprofen (Motrin).
Contraindications: Patients with liver disease should not use these medications.
Pharmacokinetics: Given PO; metabolized by the liver and excreted by the kidneys.
Side Effects: GI upset, hearing loss, liver and renal toxicity.
Nursing Care: Advise patients to take medication with food to decrease GI upset. Monitor renal and liver tests before administration. Monitor for tinnitus. Teach the patient the side effects of the medication. Always use a pain scale to assess pain. Recheck the pain level in 15 minutes.
