EENT and Sleep Disorders Q 64 - Gyan Darpan : Learning Portal
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Tuesday 22 March 2022

EENT and Sleep Disorders Q 64

For a client complaining of periocular aching after a surgical repair of a detached retina, which medication would be the most appropriate analgesic?
     A. Acetaminophen
     B. Codeine
     C. Meperidine
     D. Morphine

Correct Answer: A. Acetaminophen

Because the discomfort is typically mild after surgery to repair a detached retina, a mild analgesic such as acetaminophen would be used. Acetaminophen (APAP) is considered a non-opioid analgesic and antipyretic agent used to treat pain and fever. Clinicians can use it for their patients as a single agent for mild to moderate pain and in combination with an opioid analgesic for severe pain.

Option B: Codeine is constipating and may lead to straining and increased intraocular pressure (IOP). Constipation is one of the most common adverse effects of codeine. Most patients report some constipation following the initiation of therapy or increases in dose. With continued exposure, the resolution of constipation does not occur.
Option C: Meperidine often causes nausea and vomiting, further adding to the client’s level of discomfort, and vomiting may lead to increased IOP. Patients can have shallow or no breathing, signs of cyanosis like blue lips or fingernails, fatigue, convulsion, low blood pressure, bradycardia, constipation, stomach cramps, nausea and vomiting, cold and clammy skin, drowsiness, lightheadedness, and twitching muscles.
Option D: Morphine causes nausea, vomiting, and constipation, which should be avoided after surgery. Among the more common unwanted effects of morphine use is constipation. This effect occurs via stimulation of mu-opioid receptors on the myenteric plexus, which in turn inhibits gastric emptying and reduces peristalsis.

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