1 Opioid Analgesics

Question 1

equianalgesic

Answer 1

dose of opioid agonist that will produce the same degree of analgesia as 10mg of IM morphine

Question 2

opioid

Answer 2

any drug with actions similar to morphine

Question 3

opiate

Answer 3

compound present in opium

Question 4

DEA Schedule I-V aka…

Answer 4

Controlled Substance Schedule (CSS) aka…

Question 5

therapeutic use of agonist opioids

Answer 5

relief of moderate to severe pain

Question 6

longterm opioid use can result in…

Answer 6

…tolerance for decreased RR

Question 7

respiratory depression

Answer 7

most lethal of side effects!!!

RR < 12
can persist for several hours
can contribute to increased intracranial pressure

Question 8

high risk for respiratory depression

Answer 8

respiratory illness, med interactions

Question 9

nursing response to constipation

Answer 9

increase fluids and give meds

Question 10

adverse effects of opioids

Answer 10

• respiratory depression
• constipation
• sedation
• orthostatic hypertension
• emesis
• urinary retention
• biliary colic
• miosis (pupil constriction)
• euphoria/dysphoria
• cough suppression

THESE ARE NOT ALLERGIC REACTIONS

Question 11

abstinence syndrome

Answer 11

withdrawal

Question 12

abstinence syndrome S&S

Answer 12

initial: yawning, sweating, rhinorrhea
middle: irritability, tremor, anorexia, goosebumps
late: sneezing, weakness, N/V, diarrhea, abdominal and muscle cramping, pain

Question 13

toxicity

Answer 13

overdose

Question 14

toxicity S&S

Answer 14

• profound coma
• profound respiratory depression
• pinpoint pupils

death r/t respiratory arrest

Question 15

opioid agonist interactions

Answer 15

• CNS depressants (AKA ALCOHOL!!!)
• anticholinergics
• hypotensive agents
• agonist-antagonist opioids
• monoamine oxidase inhibitor, MAOI (depression treatment)

Question 16

predisposing conditions for opioid agonist interactions that increase riskiness of use

Answer 16

respiratory disease
liver disease
labor/delivery/pregnancy
prostatic hypertrophy
hypotension
head trauma

Question 17

CR

Answer 17

controlled release

Question 18

morphine general safe dosages

Answer 18

ORAL: 10-30mg Q4h (up to 75mg)

IM: 5-15 mg Q4h

IV: 2-10 mg Q1-2h

Equianalgesic –> 30mg PO = 10mg IM

Question 19

CNS opioid receptors x3

Answer 19

Mu (primary)
Kappa (weak)
Delta (no analgesic effects from mess)

Question 20

What effects opioid metabolism?

Answer 20

Organ dysfunction
Other meds
Administration route

Question 21

What does NOT effect opioid metabolism?

Answer 21

Pain source & location

Question 22

Pure opioid agonist (strong)

Answer 22

Morphine

Question 23

Pure opioid agonist (moderate-strong)

Answer 23

Codeine

Question 24

Agonist-antagonist opioid

Answer 24

Nalbupine (Nubain)

Question 25

Pure opioid antagonist

Answer 25

Naloxone (Narcan)