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• Good for people with general arthritis
Good Nonopioid Centrally Acting
Clonidine (Duraclom) Tramadol
• Mechanism of action
• – Combination of opioid and nonopioid mechanisms Therapeutic use
Adverse effects and interactions
– CNS depressants • Abuse liability
• Preparations, dosage, and administration
– Immediate release and extended release Clonidine
• Mechanism of pain relief
– Alpha2 adrenergic agonist
adrenergic • Analgesic use – Used in combination with opioid analgesic • Pharmacokinetics
• Adverse effects – Cardiovascular – severe hypotension, rebound
hypertension, • Contraindications
• Preparations, dosage, and administration Critical Thinking Question
Mr. L. is on a PCA (patient-controlled analgesia) pump to
manage postoperative pain related to recent orthopedic
surgery. The PCA is set to deliver MS 6mg/hr basal rate.
The nurse discovers the patient to be unresponsive with a
respiratory rate of 8 and an oxygen saturation of 84%.
What is your initial response? Subsequent actions?
Respiratory depression overdose of the narcotic
First you would verify the patient is unconscious. You would
then ask for help. Next, you would see if they’re breathing.
Then you would give CPR. You would give them narcan.
You would stop the infussion. Give them some oxygen Sample pharmacologic
chart for the
management of pain.
Although pain and its
many health care
for pain management,
including the World
Health Drugs for Headache
• 90%-95% of people in the U.S. Have
headaches each year---occur most in 20—
30 year olds.
• Number of patients seeking care is
• Living with headaches can interfere with
• Family history. Etiology of
• Common symptom
• Triggered by a variety of stimuli – Stress, fatigue, acute illness, sensitivity to
alcohol • Mild episodes
Mild – Relieved by OTCs (aspirin, acetaminophen) • Types of Severe headaches – Migraine, cluster, tension-type
• Migraine headache I: Characteristics and
overview of treatment
• Migraine headache II: Abortive therapy
• Migraine headache III: Preventive therapy
• Cluster headaches
• Tension-type headache Headaches
• Identifiable underlying causes – Severe hypertension, hyperthyroidism, tumors,
infection, and disorders of the eye, nose,
sinuses, and throat
sinuses, • No identifiable cause
– Cluster Migraine • More women than men (approximately 20% of
• Presentation: may be unilateral, pulsating
headache, with moderate to severe throbbing
pain associated with nausea, photophobia, may
last up to 72 hours.
• Associated with triggers.
• Two primary goals for the p...
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- Spring '14
- Pharmacology, Morphine