Analgesics Overview

Analgesics are medications that help relieve pain. They include:

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
• Acetaminophen (Tylenol)
• Aspirin

Definition of Analgesic

• "An-" means without, "algesia" means feeling pain.
• Analgesics aim to relieve pain.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

• Examples include Ibuprofen (Advil), Celecoxib (Celebrex), Ketorolac (Toradol), and Naproxen (Aleve).
• Functions:
  • Analgesic (pain relief)
  • Anti-inflammatory
  • Antipyretic (fever reducer)
  • Does NOT have anti-platelet effects.

Mechanism of Action

• Inhibit prostaglandin synthesis by blocking cyclooxygenase (COX) enzymes:
  • COX-1: Maintains stomach lining.
  • COX-2: Responsible for inflammation and pain.
• By blocking COX enzymes, NSAIDs reduce pain and inflammation.

Side Effects and Risks

• GI Upset:
  • Nausea, diarrhea, vomiting, abdominal discomfort, acid reflux.
  • Cause due to inhibition of COX-1.
• Nephrotoxicity:
  • Impaired renal function due to vasoconstriction.
  • Memory trick: "NSAIDs think nephrotoxic."
• Fluid Retention:
  • Increases heart workload, potential hypertension, risk of heart failure.
• Stroke Risk:
  • Increased risk with non-aspirin NSAIDs due to reduced COX enzyme production.

Contraindications

• Asthma Patients:
  • Increased risk for bronchospasms.
  • Memory trick: "Ban NSAIDs from asthma patients."

Nursing Considerations

• Monitor renal function (BUN, creatinine levels, urinary output).
• Report output below 30mL/hour immediately.

Patient Education

• Take NSAIDs with food to minimize GI upset.
• Consider PPIs like Omeprazole if acid reflux occurs.
• Report GI bleed signs (black tarry stools, coffee ground emesis, abdominal cramping).

Key Points to Remember

• NSAIDs inhibit COX-1 and COX-2.
• Risk for nephrotoxicity and GI upset.
• Avoid in asthma patients.
• Report GI bleed symptoms immediately.

Aspirin

• Effects:
  • Analgesic
  • Anti-inflammatory
  • Antipyretic
  • Anti-platelet

Acetaminophen (Tylenol)

• Effects:
  • Analgesic
  • Antipyretic
  • Does NOT have: Anti-inflammatory or anti-platelet effects.