2.1 Opioid Analgesics Flashcards
Analgesics are…
Drugs that relieve pain without loss of consciousness or sensation
Mechanism of Action: Agonist
Bind to an opioid receptor in the brain to cause an analgesic response
Ex: Morphine sulfate, hydromorphone
Mechanism of action: Partial agonist
AKA agonist-antagonist
Binds to a receptor and causes a response that is less than that caused by a full agonist
Ex: pentazocine, talwin
Mechanism of action: Antagonist
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)
Opioid Analgesics relieve ____ to ____ pain
Moderate to severe
T/F opioid analgesics can be combined with anesthetics to maintain balanced anesthesia
True
How do opioid analgesics affect the cough centre?
They suppress coughing
What effect do opioid analgesics have on the GI system?
They are an antidiarrheal
Indications for opioid analgesics
Relieves moderate to severe pain
Other uses
Cough centre suppression
Antidiarrheal
Can be combined with anesthetics to maintain balanced anesthesia
T/F Opioid analgesics can be given if the patient has asthma or other respiratory insufficiencies
False
Opioid analgesics should not be given if the patient has an ____ intracranial pressure
Elevated
T/F opioid analgesics cannot be given during pregnancy
True
Contraindications
Known drug allergy
Severe asthma or respiratory insufficiency
Elevated intracranial pressure
Pregnancy
T/F Euphoria is a side effect of opioid analgesics
True
A side effect is histamine release. What are some signs and symptoms of this?
Itching, rash, diaphoresis, flushing
How can opioid analgesics affect the respiratory system?
They are CNS depressants, so they can cause respiratory depression
What effects can opioid analgesics have on the GI tract
Nausea and vomiting
Constipation
opioid analgesics can cause urinary ____
retention
opioid analgesics have pupillary constriction as a side effect. This is known as…
Miosis
Side effects
Euphoria
Histamine release
-itching (pruritus), rash, diaphoresis, flushing
CNS depression
-Respiratory depression
GI tract adverse effects
- N + V, constipation
Urinary retention
Pupillary constriction (miosis)
3 Special concerns with opioid use
Opioid tolerance
Opioid Physical Dependence
Opioid Psychological Dependence
Opioid Tolerance
Results from chronic use
Larger doses required to maintain analgesia
Opioid physical dependence
Physical adaptation to the presence of an opioid
Opioid psychological dependence
Compulsive use
Craving, need for effects other than pain relief
opioid analgesics should be taken per os. This means that…
It should be taken with food to minimize gastric upset
Nurses should encourage ____ and ____ to minimize constipation
fluids and fibre
How can nurses help to minimize orthostatic hypotension resulting from the use of opioid analgesics?
Slow position changes
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
Codeine Indications
Post-op pain
Chronic pain
Palliative care
Antitussive
Diarrhea
Codeine Dose
15-60 mg po/SC/IM/IV q4h
Do not exceed 360mg/24h
Codeine can be used in conjunction with what drugs?
Acetaminophen and caffeine. Caffeine minimizes the codeine effect (depressant and stimulant)
How much codeine is in Tylenol 1?
8mg
How much codeine is in Tylenol 2?
15mg
How much codeine is in Tylenol 3?
30mg
How much codeine is in Tylenol 4?
60mg
Morphine Indications
Post-op pain
Chronic pain
Nephrolithiasis
Palliative care
Diarrhea
Chest pain
Adjunct to general
Anesthesia
Antitussive
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
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
