2.1 Opioid Analgesics Flashcards

1
Q

Analgesics are…

A

Drugs that relieve pain without loss of consciousness or sensation

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2
Q

Mechanism of Action: Agonist

A

Bind to an opioid receptor in the brain to cause an analgesic response

Ex: Morphine sulfate, hydromorphone

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3
Q

Mechanism of action: Partial agonist

A

AKA agonist-antagonist

Binds to a receptor and causes a response that is less than that caused by a full agonist

Ex: pentazocine, talwin

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4
Q

Mechanism of action: Antagonist

A

Reverses the effect of other opioid agents. Binds to receptors and exerts no action but blocks opioid agents from binding
body’s own endorphins

Can be used in response to opioid overdose (naloxone/narcan)

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5
Q

Opioid Analgesics relieve ____ to ____ pain

A

Moderate to severe

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6
Q

T/F opioid analgesics can be combined with anesthetics to maintain balanced anesthesia

A

True

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7
Q

How do opioid analgesics affect the cough centre?

A

They suppress coughing

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8
Q

What effect do opioid analgesics have on the GI system?

A

They are an antidiarrheal

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9
Q

Indications for opioid analgesics

A

Relieves moderate to severe pain

Other uses
Cough centre suppression
Antidiarrheal
Can be combined with anesthetics to maintain balanced anesthesia

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10
Q

T/F Opioid analgesics can be given if the patient has asthma or other respiratory insufficiencies

A

False

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11
Q

Opioid analgesics should not be given if the patient has an ____ intracranial pressure

A

Elevated

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12
Q

T/F opioid analgesics cannot be given during pregnancy

A

True

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13
Q

Contraindications

A

Known drug allergy
Severe asthma or respiratory insufficiency
Elevated intracranial pressure
Pregnancy

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14
Q

T/F Euphoria is a side effect of opioid analgesics

A

True

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15
Q

A side effect is histamine release. What are some signs and symptoms of this?

A

Itching, rash, diaphoresis, flushing

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16
Q

How can opioid analgesics affect the respiratory system?

A

They are CNS depressants, so they can cause respiratory depression

17
Q

What effects can opioid analgesics have on the GI tract

A

Nausea and vomiting
Constipation

18
Q

opioid analgesics can cause urinary ____

19
Q

opioid analgesics have pupillary constriction as a side effect. This is known as…

20
Q

Side effects

A

Euphoria

Histamine release
-itching (pruritus), rash, diaphoresis, flushing

CNS depression
-Respiratory depression

GI tract adverse effects
- N + V, constipation

Urinary retention

Pupillary constriction (miosis)

21
Q

3 Special concerns with opioid use

A

Opioid tolerance
Opioid Physical Dependence
Opioid Psychological Dependence

22
Q

Opioid Tolerance

A

Results from chronic use
Larger doses required to maintain analgesia

23
Q

Opioid physical dependence

A

Physical adaptation to the presence of an opioid

24
Q

Opioid psychological dependence

A

Compulsive use
Craving, need for effects other than pain relief

25
opioid analgesics should be taken per os. This means that...
It should be taken with food to minimize gastric upset
26
Nurses should encourage ____ and ____ to minimize constipation
fluids and fibre
27
How can nurses help to minimize orthostatic hypotension resulting from the use of opioid analgesics?
Slow position changes
28
Nursing implications
Per os: taken with food to minimize gastric upset Safety measures related to sedation (over-sedation) Encourage fluids and fibre to minimize constipation Slow position change to minimize orthostatic hypotension
29
Codeine Indications
Post-op pain Chronic pain Palliative care Antitussive Diarrhea
30
Codeine Dose
15-60 mg po/SC/IM/IV q4h Do not exceed 360mg/24h
31
Codeine can be used in conjunction with what drugs?
Acetaminophen and caffeine. Caffeine minimizes the codeine effect (depressant and stimulant)
32
How much codeine is in Tylenol 1?
8mg
33
How much codeine is in Tylenol 2?
15mg
34
How much codeine is in Tylenol 3?
30mg
35
How much codeine is in Tylenol 4?
60mg
36
Morphine Indications
Post-op pain Chronic pain Nephrolithiasis Palliative care Diarrhea Chest pain Adjunct to general Anesthesia Antitussive
37
Morphine Dose
Oral: 5-200mg depending on frequency and tolerance SC or IM 10mg/70kg q4h IV 2.5-15mg/70kg over 4-5 min
38
Nursing Implications post administration
Monitor vital signs including pain rating -contact DR. if significant change Monitor for respiratory depression -R>12/m, dyspnea, diminished breath sounds, shallow breathing