- morphine sulfate (Statex) acts on opiate receptor - fentanyl citrate (Sublimaze) acts on Mu receptors - meperidine (Demerol) acts on Mu receptors - nalbuphine (Nubain) acts on opiate receptors - used for pain management contraindications - CNS depressed - head injury - resp depressed - MAOI's in 14 days - hypotension

- acts on the CNS opiate receptors - vasodilation due to depression of A receptors and baroreceptors

STEMI - 2-4mg SIVP - 5-15mg IM PAIN -2-10mg SIVP q 5-30 min

- cardiac chest pain - moderate to server pain (acute or chronic)

- acts on Mu receptors in the CNS altering pain preception - less emetic effects than other narcotics - 50-100x stronger than MS but shorter acting

Demerol (trade) - opioid - analgesic - narcotic

Nubain (trade) - opioid - analgesic - narcotic

- decrease pain preception by acting on opioid recptors - simillar strength to morphine but faster and longer acting - analgesic effects with antagonist properites to reduce risk of abuse

titrate to effect - .4mg IV/IO/IM to total max 2mg - 2mg IN q3-5 min

200's Pharmo Flashcards by brandon wolgemuth

Opioids

Narcotics

morphine sulfate (Statex) acts on opiate receptor
fentanyl citrate (Sublimaze) acts on Mu receptors
meperidine (Demerol) acts on Mu receptors
nalbuphine (Nubain) acts on opiate receptors
used for pain management

contraindications

CNS depressed
head injury
resp depressed
MAOI’s in 14 days
hypotension

How well did you know this?

Not at all

Perfectly

morphine sulfate (generic name)

MS contin statex (trade)
class
- opioid
- analgesic
- narcotic

How well did you know this?

Not at all

Perfectly

morphine-MOA

acts on the CNS opiate receptors

- vasodilation due to depression of A receptors and baroreceptors

How well did you know this?

Not at all

Perfectly

morphine-dose

STEMI

2-4mg SIVP
5-15mg IM

PAIN
-2-10mg SIVP q 5-30 min

How well did you know this?

Not at all

Perfectly

morphine-indications

cardiac chest pain

- moderate to server pain (acute or chronic)

How well did you know this?

Not at all

Perfectly

morphine-contraindications

hypotension
allergy to codeine
altered LOC
head injury
severe resp depression
MAOI’s within 14 days
undiagnosed abdo pain

PRECAUTIONS

use caution with RVI’s
resp compromised
pt’s with other CNS depressant

How well did you know this?

Not at all

Perfectly

fentanyl citrate (generic)

Sublimaze (trade)

opioid
analgesic
narcotic

How well did you know this?

Not at all

Perfectly

fentanyl MOA

acts on Mu receptors in the CNS altering pain preception
less emetic effects than other narcotics
50-100x stronger than MS but shorter acting

How well did you know this?

Not at all

Perfectly

fentanyl indications

severe pain panagment

- RSI

How well did you know this?

Not at all

Perfectly

fentanyl contraindications

MAOI’s within 14 days
severe hemorrhage
head injury
hypotension
Myasthenia gravis

Precautions

bradycardia
hepatic or renal failure

How well did you know this?

Not at all

Perfectly

meperidine (generic)

Demerol (trade)

opioid
analgesic
narcotic

How well did you know this?

Not at all

Perfectly

meperidine MOA

acts on Mu and Kappa opiate receptors in the CNS

- greater affinity for Kappa than morphine causing increased dysphoria but does not have the same hemodynamic properties

How well did you know this?

Not at all

Perfectly

meperidine dose

25-50mg IV q 3-4 hours

How well did you know this?

Not at all

Perfectly

meperidine indications

-moderate to severe pain

How well did you know this?

Not at all

Perfectly

meperidine contracations

MAOI’s or SSRI’s within 14 days

head injury
undiagnosed abdo pain

Precautions
-phenytoin may decrease analgesic effects

How well did you know this?

Not at all

Perfectly

fentanyl dose

pain managment
-.5-1 mcg/kg SIVP

RSI
-2-5 mcg/kg IV
or
-1-3 mcg/kg IV if hypotensive

How well did you know this?

Not at all

Perfectly

nalbuphine (generic)

Nubain (trade)

opioid
analgesic
narcotic

How well did you know this?

Not at all

Perfectly

nalbuphine dose

5mg SIVP followed by 2mg titrated to effect

How well did you know this?

Not at all

Perfectly

nalbuphine MOA

decrease pain preception by acting on opioid recptors
simillar strength to morphine but faster and longer acting
analgesic effects with antagonist properites to reduce risk of abuse

How well did you know this?

Not at all

Perfectly

nalbuphine indications

moderate to severe pain

How well did you know this?

Not at all

Perfectly

nalbuphine contraindications

head injury
undiagnosed abdo pain

precautions
-may cause withdrawal in opiate dependant patients

How well did you know this?

Not at all

Perfectly

naloxone (generic)

Narcan (trade)

-opioid antagonist

How well did you know this?

Not at all

Perfectly

naloxone dose

titrate to effect

.4mg IV/IO/IM to total max 2mg
2mg IN q3-5 min

naloxone MOA

narcotic antagonist
competes for narcotic (opioid) receptors in the CNS but has a higher affinity
works with both narcotics and synthetic narcotics

naloxone indication

CNS and resp depression induced by opioids

naloxone contraindications

-hypersensitivity precautions - narcotic dependance - decreases effectiveness of any opioids administered

acetaminophen (generic)

Tylenol (trade) - analgesic - antipyretic

acetaminophen dose

- 325-650mg PO q 4 hrs | - to a max of 4gs (4000mg) per day

acetaminophen MOA

- acts on the hypothalamus to produce antipyresis - may potentially block pain impulses - may inhabit prostaglandin synthesis in the CNS

acetaminophen indications

- fever | - mild pain

acetaminophen contraindications

- severe acute liver disease - hypersensitivity precautions - altered LOC - NV - angioedema

``` ASA acetylsalicylic acid (generic) ```

Asprin (trade) - antiplatelet (platelet inhibitor) - analgesic - anti-inflammatory - antipyretic

ASA MOA

- changes surface of platelets decreasing the ability to clot - blocks the formation of thromboxane A2

ASA dose

chest pain -160-325 mg PO (chewed) mild pain or fever -325-650 mg PO q 4hrs

ASA indications

- chest pain - fever - minor pain

ASA contraindications

- hypersenseitivity ro ASA or NSAIDS - active bleed (internal or external) precautions - bleeding disorder - active ulcers - bronchoconstriction in asthmatics

diazepam (generic)

Valium (trade)

diazepam class

Benzodiazepine anticonvulsant antianxiety sedative

diazepam dose

seizure 5-10mg SIVP cardioversion 5-15mg SIVP anxiety 2-5mg SIVP/IM

diazepam MOA

potentiating effects of GABA

diazepam indications

- status epilepticus - seizure - cardioversion - sedation - anxiety

diazepam contraindacations

- substance abuse (relative) - CNS depressed due to head injury - resp depression - severe hypotension - shock - hypersensitivity Precaution -short acting due to water solubility

lorazepam (generic)

Ativan (trade)

lorazepam class

- Benzodiazepine - anticonvulsant - antianxiety - sedative

lorazepam MOA

-potentiating effects of GABA

lorazepam dose

seizure 0.5-2mg SIVP anxiety/withdrawal 1-4mg IM 1mg SL

lorazepam indications

- status - seizure - cardioversion - sedation - anxiety - withdrawl

lorazepam contracations

- CNS depressed - headinjury - resp depression

Benzodiazepines anticonvulsants antianxiety sedatives

lorazepam (Ativan) diazepam (Valium) midazolam (Versed) - all potentiate the effects of GABA - used for seizures, sedation and anxiety - contraindications CNS or resp depressed

midazolam (generic)

Versed (trade)

midazolam calss

- benzo - anticonvulsant - antianxiety - sedative

midazolam MOA

potentiates GABA

midazolam dose

sedation -1-2.5mg SIVP (5-10mg SIVP AHS) seizure -1-2.5mg SIVP RSI -0.1-0.3mg/kg SIVP

midazolam indications

- seizures - sedation - status - cardioversion - anxiety

midazolam contraindications

- severe hypotension - CNS depressed - head injuried - resp depression - substance abuse

flumazenil (generic)

Anexate (trade)