Comprehensive Nursing Pharmacology Q 296
The physician orders an intramuscular injection of Demerol for the postoperativepatient’s pain. When preparing to draw up the medication, the nurse is careful to remove the correct vial from the narcotics cabinet. It is labeled
A. Simethicone.
B. Albuterol.
C. Meperidine.
D. Ibuprofen.
Correct Answer: C. Meperidine.
The generic name for Demerol is meperidine. Meperidine, also known as pethidine, is in the class of phenylpiperidine as a hydrochloride salt synthetic form of the opioid, which is a white crystalline with a melting point of 186 degrees C. This medication has calcium sulfate, dibasic calcium phosphate, starch, stearic acid, and talc as inactive ingredients. Clinicians use meperidine for the treatment of moderate to severe pain. Meperidine has the same mechanism of action as morphine, which is acting as an agonist to the mu-opioid receptor. The anti-shivering effect may involve the stimulation of k-opioid receptors.
Option A: Simethicone is a silicone compound used for the management of flatulence and bloating. It relieves the discomfort produced by the presence of excess gas in the gastrointestinal tract. Simethicone is a silicone compound that functions as a non-systemic surfactant, decreasing the surface tension of gas bubbles in the GI tract. This action results in coalescence and dispersion of the gas bubbles allowing their removal from the GI tract as flatulence or belching. Simethicone Dimethicone causes the gas bubbles to accumulate and therefore pass more easily either through the upper GI or lower GI opening.
Option B: Albuterol, also known as salbutamol, has an indication for the treatment and prevention of bronchospasm (acute or severe) in patients with reversible obstructive airway disease, including exercise-induced bronchospasm. Albuterol acts on beta-2 adrenergic receptors to relax the bronchial smooth muscle. It also inhibits the release of immediate hypersensitivity mediators from cells, especially mast cells. Although albuterol also affects beta-1 adrenergic receptors, this is minimal and has little effect on the heart rate.
Option D: Ibuprofen is indicated and FDA-approved for use in the treatment of inflammatory diseases and rheumatoid disorders. Ibuprofen is also FDA-approved for use in mild to moderate pain. It is also available as an over-the-counter medication for pain, usually mild. Ibuprofen is also an FDA-approved antipyretic, used for fever reduction in both adults and children. The use of NSAIDs in treating fever is much more commonplace in pediatric patients, and much contemporary research centers around creating more efficacy in the usage of ibuprofen in treating pediatric fever. The primary mechanism of Ibuprofen, an NSAID, is through the inhibition of prostaglandin precursors.