Review Adjuvant Analgesics

Analgesics and Pain Management Medications > Pharmacology

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Adjuvant Analgesics

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Total Questions : 5

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Question 1:

A nurse is caring for a client who has neuropathic pain due to diabetic neuropathy.
Which of the following adjuvant analgesics can the nurse administer to this client?

A. Amitriptyline B. Etidronate C. Methyphenidate D. Hydroxyzine.

Answer and Explanation

Choice A:

Amitriptyline is a tricyclic antidepressant that can be used as an adjuvant analgesic for neuropathic pain. It works by inhibiting the reuptake of serotonin and norepinephrine, which are neurotransmitters involved in pain modulation.

Choice B:

Etidronate is wrong because it is a bisphosphonate that is used to treat osteoporosis and Paget’s disease of bone, not neuropathic pain.

Choice C:

Methylphenidate is wrong because it is a stimulant that is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, not neuropathic pain.

Choice D:

Hydroxyzine is wrong because it is an antihistamine that is used to treat allergic reactions, anxiety, and insomnia, not neuropathic pain.

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Question 2:

A nurse is preparing to administer pamidronate to a client who has bone pain due to metastatic cancer.
Which of the following statements by the client indicates a need for further teaching?

A. “I will drink plenty of water before and after receiving this medication.” B. “I will have my dental check-up before starting this medication.” C. “I will take this medication with food to prevent stomach upset.” D. “I will report any signs of fever, fatigue, or nausea.”.

Answer and Explanation

Choice A:

Drinking plenty of water before and after receiving pamidronate can help prevent dehydration and kidney damage.

Choice B:

Having a dental check-up before starting pamidronate can help prevent osteonecrosis of the jaw

Choice C:

The client should not take pamidronate with food because it can decrease the absorption of the medication and reduce its effectiveness.The client should take pamidronate on an empty stomach at least 2 hours before or after eating.

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Question 3:

A nurse is reviewing the medication history of a client who has chronic pain and is prescribed dexamethasone as an adjuvant analgesic.
Which of the following statements by the client should alert the nurse to a possible adverse effect of this medication?

A. “I have been feeling more thirsty and hungry lately.” B. “I have been having trouble falling asleep at night.” C. “I have been experiencing some tingling and numbness in my feet.” D. “I have been noticing some bruises on my arms and legs.”.

Answer and Explanation

Choice A:

This statement by the client should alert the nurse to a possible adverse effect of dexamethasone, which is hyperglycemia. Dexamethasone is a steroid medication that has analgesic, antiemetic, and anti-inflammatory properties, but it can also increase blood glucose levels by stimulating gluconeogenesis and reducing insulin sensitivity. The nurse should monitor the client’s blood glucose levels and report any signs of hyperglycemia, such as polydipsia, polyphagia, and polyuria.

Choice B:

Insomnia is a common side effect of dexamethasone, but not a serious adverse effect. The nurse should advise the client to take dexamethasone in the morning to reduce the risk of insomnia and to avoid caffeine and alcohol before bedtime.

Choice C:

Tingling and numbness in the feet are not related to dexamethasone use. They could indicate peripheral neuropathy, which could have other causes such as diabetes, vitamin B12 deficiency, or nerve compression. The nurse should assess the client’s feet for sensation, circulation, and skin integrity and refer the client to a neurologist if needed.

Choice D:

Dexamethasone, but not a serious adverse effect. Dexamethasone can cause skin thinning and fragility, which can lead to easy bruising and delayed wound healing. The nurse should instruct the client to avoid trauma to the skin and to apply pressure to any bleeding sites. Normal ranges for blood glucose are 70-110 mg/dL (3.9-6.1 mmol/L) for fasting and <140 mg/dL (<7.8 mmol/L) for postprandial.

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Question 4:

A nurse is educating a client who has fibromyalgia about the use of pregabalin as an adjuvant analgesic.
Which of the following information should the nurse include in the education?

A. Pregabalin can cause bone marrow suppression, so regular blood tests are needed. B. Pregabalin can cause weight loss, so monitor your weight and nutritional intake. C. Pregabalin can cause drowsiness, so avoid driving or operating machinery. D. Pregabalin can cause rash, so stop taking it and notify your provider if you develop one.

Answer and Explanation

Choice A:

Pregabalin does not cause bone marrow suppression. This is a serious side effect of some other drugs, such as chemotherapy agents, but not pregabalin.

Choice B:

Pregabalin can cause weight gain, not weight loss. This is another common side effect of pregabalin, which may affect about 1 in 18 people who take it. Therefore, patients should monitor their weight and nutritional intake while taking pregabalin.

Choice C:

Pregabalin can cause drowsiness, so avoid driving or operating machinery. This is a common side effect of pregabalin, which is a drug that is used to treat the pain of fibromyalgia. Pregabalin works by reducing the abnormal electrical activity in the brain that causes pain.

Choice D:

Pregabalin does not cause rash. This is a rare side effect of some other drugs, such as antibiotics, but not pregabalin. However, if patients develop any signs of allergic reaction to pregabalin, such as swelling of the face, lips, tongue, or throat, they should stop taking it and notify their provider immediately.

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Question 5:

(Select all that apply) A nurse is teaching a client who has cancer pain about the use of adjuvant analgesics.
Which of the following statements should the nurse include in the teaching?

A. “Adjuvant analgesics can help reduce the dose or side effects of opioids.” B. “Adjuvant analgesics can treat various types of pain that are difficult to manage with conventional analgesics.” C. “Adjuvant analgesics can cure the underlying cause of pain.” D. “Adjuvant analgesics can enhance the efficacy of nonopioids or opioids.” E. “Adjuvant analgesics can relieve associated symptoms of pain such as anxiety or insomnia.”.

Answer and Explanation

Choice A:

Adjuvant analgesics are drugs that are not primarily designed to control pain, but have an analgesic effect on their own or when used with other pain medications.They are especially useful for neuropathic pain and pain syndromes like fibromyalgia.They can also help with cancer pain by reducing the dose or side effects of opioids, treating various types of pain that are difficult to manage with conventional analgesics, enhancing the efficacy of nonopioids or opioids, and relieving associated symptoms of pain such as anxiety or insomnia.

Choice B:

Choice C:

Adjuvant analgesics cannot cure the underlying cause of pain.They only help to manage the pain and improve the quality of life of the patient.

Choice D:

Choice E:

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Adjuvant Analgesics

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