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ANALGESIC DRUG

1. PARACETAMOL

Trade name : panadol

Functional class : Nonopiods analgesic, antipyretic

Chemical class : Nonsalicylate, paraaminophenol derivative

Action : May block pain impulses peripheral that occur in

response to inhibition of prostaglandin synthesis; does

not possess anti-inflammatory properties; antipyretic

action result from inhibition of prostaglandin in CNS

(hypothalamic heat-regulating center)

Uses : Mild to moderate pain or fever, arthralgia, dental pain,

dysmenorrhea, headache, myalgia and osteoarthritis.

Dosage : tab 1g, suppository 80,120, 125, 325, 600, 650 g

Side effect : hepatotoxocity, hepatic fever, renal failure, cynosis,anemia, neutropenia, jaundice.

Nursing consideration : Dont give exceed recommended dosage..

Not to use with alcohol, herbals, without approval

of prescriber. To notify if pain or fever lasting over

3days.

2. KETOROLOC

Trade name : Toradol

Functional class : Nonsteroidal anti-inflammatory/nonopiod analgesic Chemical class : Acetic acid

Action : Inhibits prostaglandin synthesis by decreasing an

enzyme needed for biosynthesis; analgesic, anti-

inflammatory and antipyretic effects

Uses : Mild to moderate pain (short term) seosanal allergic

conjunctivitis (ophthalmic)

Dosage : 15/30 mg/ml, tab 10mg

Side effects : CV trombotic events, MI, stroke, GI bleeding,

perforation, nephrotoxicity, blood drscrasias.

Nursing consideration: Patient with aspirin sensitivity, asthma, may bemore .ikely to develop hypersentiviti to NSAIDs.,

monitor for hypersensitivity. Not to exceed 5 days.

Avoid driving if dizziness or drowsiness occurs.

Report any urine patern, weight increase, edema,

pain increase in joint, fever, blood in urine. Avoid

alcohol.

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3. INDOMETHACIN

Trade name : Novomethacin

Functional class : Nonsteroidal anti-inflammatory product

(NSAIDs), antirheumatic

Chemical class : Propionic acid derivative

Action : Inhibits prostaglandin synthesis by increasing enzyme needed

for biosynthesis; analgesic, anti-inflammatory and antipyretic

effects

Uses : Rheumathoid arthritis, ankylosing spondylitis, osteoarthritis,

bursitis, tendernitis, acute gouty arthritis, closure of patent

ductus arteriosus in premature infants, ICU- dysmenorrheal,

inflammatory disease.

Dosage : 25-50 mg BD/QID, max 200mg/day

Side effect : dizziness, drowsiness, fatigue, tachycardia, peripheraledema, palpitations, ulceration, perforation, nephrotoxicity.

Nursing consideration : take with food to decrease GI symptom and

perevent ulcerations. Shake suspension and do not mix with

orther liquids. Avoid alcohol, NSAIDs, salicylates: bleeding

may occur.

4. FENTANYL

Functional class : Opiods analgesic

Chemical class

: synthetic phenylpiperidine

Action : Inhibits ascending pain pathways in CNS, increase pain

threshold, alters pain perception by binding to opiate

receptors.

Uses : Control moderate to severe pain, pre-op, post-op; adjunct to

general anesthetic, adjunct to regional anesthesia. Fentanyl;

anesthesia as premedication, conscious sedation. For treatment

cancer and palliative care ( rheumathoid arthritis)

Dosage : IV : 25-100mcg, IM /IV 0.1mg 30-60min before operation,

25mcg/hour (patch).

Side effect : Dizziness, delirium, sedation, bradycardia,cardiac andrespiratory arrest, respiratory depression, laryngospasam,

lightheadedness, weakness and fatigue, dry mouth and

constipation.

Nursing consideration : CNS changes, allergic changes, respiratory

dysfunction, give slowly to prevent rigidity (IM/IV)

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5. LOCAL ANESTHETICS

( LIDOCANE, ROPIVACAINE, PROCAINE, TETRACAINE)

Action : Inhibits conduction of nerve impulses from sensory

nerve.

Uses : Refer to individual product listing for indications.

Side effect : dystonia, akathisia, flexion of arm, fine tremors,

drowsiness, restlessness, and hypotension, chills,

respiratory depression and laryngospasm.

Precaution : Pregnancy

6. MORPHINE

Functional class: Opiods analgesic

Chemical class : Alkaloid

Action : Depression pain impulse transmission at the spinal cord

level by interacting with opioid receptors.Uses : Moderate to severe pain , left ventricular failure,

analgesic for terminal care.

Dosage : IM/IV/SC 0.5-50mg/ml, tab 15/30mg, liq 10,20mg/ml,

Antidote : Naloxone

Side effect : Hypotension, bradycardia, respiratory depression,

drowsiness, nausea, vomiting, constipation, pruritis.

Nursing consideration : CNS changes, allergic reaction, turn position

slowly orthostatic and hypotension may occur, avoid use

alcohol and CNS depressants.

7. CODEINE

Functional class : Opiates analgesic, antitussive

Chemical class : Opiates, phenathrene derivative

Action : Depression pain impulse transmission at the spinal cord

level by interacting with opioid receptors, decreases

cough reflex, GI motility

Uses : Moderate to severe pain, nonproductive cough

Dosage : tab 15-30mg, inj 15,30mg/ml

Antidote : Nalaxone Side effect : drowsiness, sedation, dizziness, agitation, seizures,

bradycardia, palpitation, orthostatic, hypotension,

tachycardia, respiratory depression, respiratory paralysis,

anaphylaxis, circulatory prolapse.

Nursing consideration: not to breastfeed, CNS changes, allergic reaction,

avoid hazardous activity

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8. METHADONE

Functional class: Opioid analgesic

Chemical class : Synthetic diphenylhapatane derivative

Action : Depression pain impulse transmission at the apinal card

level by interacting with opioid receptors, produce CNS

depression.

Uses : severe pain, opioid withdrawal

Dosage : tab 5-10mg, inj 5-10mg/5ml

Antidote : Nalaxone

Side effect : drowsiness, dizziness, confusion, headache, seizures,

respiratory depression or arrest,cardiac arrest, shock

9. TRAMADOL

Trade name : Tramal

Functional class : Analgesic Action : Not completely understood, binds to opioid receptors,

inhibits reintake of norepinephrine, serotonin; does not

cause histamine release or affect heart rate

Dosage : tab 15mg

Side effect : dizziness, headache, hallucination, sedation,

vasodilation, orthostatic hypotension, tachycardia,

hypertension, dry mouth, constipate, anorexia,

anaphylaxis.