PUSRAWI INTERNATIONAL COLLEGE OF MEDICAL SCIENCES

DIPLOMA IN NURSING
FORMATIVE ASSESMENT PHARMACOLOGY PDNHS 2153

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NAME
FATIN SYAZWANI BT ABDUL RAHIM
IMAN ATHIKA BT LAILI
NORSHUHADAH ATIKAH BT KAMARUL AZMAN
NUR HAIDATUL AKMA BT NOR AZMAN
NURHAYATI BT MD SHAH
NURILLA SYAFIERA BT REDUAN

MATRIX NUMBER
NG07140016
NG07140019
NG07140049
NG07140073
NG07140095
NG07140099

GROUP: JULY 14 (A)

LECTURERS NAME: PUAN RUMIZA BT REJAB
TOPIC: ANALGESIC DRUGS
SUBMISSION DATE: 6th Nov 2015

CONTENT

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CONTENT
Picomss vision and mission
Appreciation
Objective learning
Introduction
Opioids
Type of opioids
Non-opioids
Type of non-opioids
NSAIDs
Type of NSAIDs
Nursing responsibilities
References

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PICOMSS VISSION

Turning dreams into reality, our vision is to be the nations top provider of health and medical
sciences with academic excellence and holistic patient care graduates by the year 2020

PICOMSS MISSION

We strive to be fully committed and to maintain high academic standards in producing quality
graduates with excellent knowledge, skills and attitudes in all aspects of health services

APPRECIATION

Assalamualaikum. First of all, I am bless to Allah for give us this opportunity to complete this
assignment. I would like to thank Pn Rumiza our pharmacologys lecturer for gave us a
precious knowledge and helped us through ups and downs. Next, I would like to thank our

parents for support us in many way such as finance, transport and all the other stuff to
complete this project. Furthermore, thank you to each members in this group for did their
own roles and task that been given to them, all the cooperation from each members to
complete this project. I am thankful because this project taught us how to be a responsible
and reliable student nurse.

OBJECTIVE LEARNING

1. List the types of analgesic drugs

2. Identify the uses of each analgesic drugs
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Identify trade name and generic name for every analgesic drugs
State the indication and contraindication of each analgesic drugs
List the side effect for taking analgesic drugs
Apply the skills of giving analgesic drugs

INTRODUCTION

An analgesic or painkiller is any member of the group of drugs used to achieve analgesia,
relief from pain. Analgesic drugs act in various ways on the peripheral and central nervous
systems. Analgesic are medications designed to relieve the symptoms of pain. There are
number of different groups of analgesic including:

Opioids (opium or morphine)

Non-opioids (simple analgesic)
Non-steroidal anti-inflammatory drugs (NSAID)

OPIOIDS

Opioids are substances that act on the nervous system in a similar way to opiates such as
morphine and codeine. In a medical context the term usually indicates medications that are
artificially made rather than extracted from opium. Opioids are primarily used in medicine for
the treatment of pain. Opioids (narcotic) analgesic are derived from or related to the opium.
They bind to opioid receptors which present in many regions of the nervous systems and are
involved in pain signalling and control. There are four groups of opioids receptor including
delta, kappa, mu, and sigma. Opioids analgesic relieve pain by acting directly on the central
nervous system. Opioids are unique in that they not only block the incoming nociceptive
signals to the brain but also act at higher brain centers controlling the affective components of
the pain. Opioids analgesic are more effective than NSAIDs in providing pain relief. Opioids
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are much stronger and are used when pain signals are too severe to be controlled by nonnarcotic analgesic. The opioids reduce pain working on special pain receptors in the nervous
system primarily located in the brain and spinal cord. The opioids decrease the brains
awareness of the pain.

TYPES OF OPIOIDS

Generic name
Trade name
Indication

MORPHINE
Astramorph, Duramorph
Severe pain, pulmonary oedema, pain

Contraindication

associated with MI
Severe renal, pulmonary disease, high

Action

intracranial pressure
Response to painful stimuli while producing

Dosage

generalized CNS depression

PO: 10-20mg
IM, SUBCUTANEOUS: 10mg

Side effect

EPIDURAL: 5mg
Confusion, dizziness, bradycardia, nausea
and constipation

Generic name
Trade name
Indication

TRAMADOL
Ralivia, Ryzoh, Ultram
Patient who required around the clock pain

Contraindication

management
Hypersensitivity, acute or severe bronchial
asthma, patient who are physically

Action

depended on opioid analgesic

Decreased pain, inhibit reuptake of

Dosage

serotonin and norepinephrine in the CNS

PO: Age above 18yrs 50-100mg

Side effect

Age above 75yrs 300mg/day

Dizziness, headache, constipation, nausea

Generic name
Trade name
Indication
Contraindication

METHADONE
Dolophine, metadol, methadose
Severe pain
Hypersensitivity, hypokalaemia, history of

Action
Dosage

arrhythmia
Decrease in severity of pain
PO: 20-30mg

Side effect

PARENTRAL: 2.5-10mg every 8-12hrs

Dizziness, confusion, headache, blurred
vision

NON OPIOIDS

Simple non-opioids analgesic are the most common form of analgesic and the most common
drug in this group is paracetamol. Non-opioids (non-narcotic) include acetaminophen the
most commonly used over the counter analgesic effective for mild to moderate headache and
pain of musculoskeletal origin. Non-opioids analgesic have principally analgesic, antipyretic
and anti-inflammatory actions. Non-opioids act primarily in peripheral tissues to inhibit the
formation of pain producing substances such as prostaglandins. They do not bind to opioids
receptors and are not classified under the controlled substances. They are milder forms of the
painkiller. The non-opioids work more directly on injured body tissues whereas the nonopioids affect some of the chemical changes that normally take place wherever body tissues
are injured or damaged. These chemical changes at the site of the injury typically result in
inflammation and increased pain sensitivity.

TYPES OF NON OPIOIDS

Generic name
Trade name
Indication
Contraindication

KETOROLAC
Sprix, toradol
Short term management of pain
Hypersensitivity, active of peptic ulcer, third

Action

trimester pregnancy
Producing peripherally mediated analgesia,

Dosage
Side effect

decreased pain
PO: 20mg
Stroke, MI, stevens-johnson syndrome

Generic name
Trade name
Indication

DICLOFENAC
Cambia, voltaren, pennsaid
Management of inflammatory disorder,
osteoarthritis, relief of mild to moderate

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Contraindication

pain
Hypersensitivity, active GI bleeding,

Action
Dosage

eczema
Suppression of pain and inflammation
PO: 100mg

Side effect

Dizziness, headache, hypertension, acute

renal failure, GI bleeding

Generic name
Trade name
Indication

ETODOLAC
Iodine, iodine XL
Mild to moderate pain, osteoarthritis,

Contraindication

rheumatoid arthritis
Hypersensitivity, active GI bleeding, second

Action
Dosage
Side effect

half of pregnancy
Decreased severity of pain
PO: 200-400mg
Depression, dizziness, insomnia,
hypertension, dysuria, anaemia

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NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAID)

Nonsteroidal anti-inflammatory drugs usually abbreviated to NSAIDs also called

nonsteroidal

anti-inflammatory

agents/analgesics

(NSAIAs)

or

nonsteroidal

anti-

inflammatory medicines (NSAIMs) are a class of drugs that provides analgesic (anti killing)
and antipyretic (fever reducing) effects and in higher doses used for anti-inflammatory
effects. NSAIDs are usually used for the treatment of acute or chronic conditions where pain
and inflammation are present. NSAIDs provide effective relief of many types of acute and
persistent pain especially associated with inflammation. Prescribed alone, these agents can
relieve slight to moderate pain. Alternatively, for moderate to severe pain, they can be used in
combination with opioids to enhance pain relief.

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TYPES OF NSAIDs

Generic name
Trade name
Indication

IBUPROFEN
Genpril, caldolor
Moderate pain, fever, osteoarthritis,

Contraindication

dysmenorrhea
Active GI bleeding, ulcer disease, preoperative coronary artery bypass graft

Action

(CABG)
Inhibits prostaglandin synthesis, decreased

Dosage

pain, inflammation and reduction fever

PO: Infants 4-10mg

Side effect

Adults 400-800mg
Dizziness, tinnitus, constipation, cystitis,
renal failure, prolonged bleeding time

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Generic name
Trade name
Indication

DICLOFENACT
Voltaren, voltaren gel, flector
Rheumatoid arthritis, osteoarthritis,

Contraindication

migraines, keratosis, sprains and contusions

Active GI bleeding, eczema, cardiovascular

Action

disease, second trimester pregnancy

Suppression of pain and inflammation,

Dosage
Side effect

relief acute migraine

PO: 25mg, 50mg, 75mg
Contact dermatitis, dry skin, exfoliation

Generic name
Trade name
Indication
Contraindication

MEFENAMIC ACID
Postan
Dysmenorrhea, metrorhagias
Pregnancy, kidney problem, GIT

Action

inflammation, bypass heart surgery

Treating moderate pain, treating menstrual

Dosage
Side effect

pain
PO: 250-500mg
Diarrhoea, dyspepsia, heartburn, dizziness,
anaemia, conjunctivitis, flatulence

NURSING RESPONSIBILITIES
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Asses type, location and intensity of pain

Asses bowel function routinely
Monitor intake and output ratio
Asses blood pressure, pulse and respiration before and during administration
Analgesic is more affective if given before pain become more severe
Regularly admistered doses may be more effective than prn admistered
Coad ministration with non-opioids analgesic may have additive analgesic effect
and may be permit lower doses

REFERENCES

www.emedexpert.com/compare/opioids.shtml
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 www.arthritisresearchuk.org/arthriris-information/drugs/painkillers/simple-non-opioidanalgesics.aspx
http://en.m.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug
http://en.m.wikipidea.org/wiki/Opioid
Vallerand sanoski with deglin, Thirteenth edition, Davids drug guide for nurses, F.A
davis
Edisi kedua, Kamus jururawat, Oxford fajar

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