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CLIN MED Surgery > 39 - Opioid analgesics - ha > Flashcards

39 - Opioid analgesics - ha Flashcards

1
Q

Opioid that provides relief for moderate to severe acute and chronic pain.

A

Morphine

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2
Q

Pure opioid.

A

Morphine

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3
Q

In addition to reducing pain, what are other indications for Morphine?

A
  • Induce sleep
  • Treat diarrhea
  • Relief of dyspnea (pulmonary edema assoc. w/LVF)
  • Antitussive
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4
Q

Dangers of morphine:

A

Respiratory depression
Dependency/Abuse
Severe Hypotension

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5
Q

What should you always prescribe along with Morphine to avoid one of its major side effects?

A

Laxative

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6
Q

Semisynthetic analogue of morphine AND codeine.

A

Hydromorphone (Dilaudid)

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7
Q

Semisynthetic analogue of CODEINE.

A

Hydrocodone (Vicodin)

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8
Q

This is 5x more potent than morphine. It relieves moderate to SEVERE pain.

A

Hydromorphone (Dilaudid)

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9
Q

Why is hydromorphone an antitussive?

A

It directly acts on the medulla to suppress cough

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10
Q

Combination of a centrally-acting analgesic (codeine) and peripherally-acting analgesic (acetaminophen).

A

Tylenol w/Codeine (T3)

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11
Q

Slightly less potent than morphine; relief of mild to moderate pain.

A

Tylenol w/codeine

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12
Q

When taking T3 or percocet, what should your patient avoid?

A

Other products that contain acetaminophen! Do not exceed 3000mg per day (per PKM)

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13
Q

Combination of hydrocodone and acetaminophen.

A

Hydrocodone (Vicodin)

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14
Q

Hydrocodone (Vicodin) is used for what type of pain?

A

Similar potency as morphine; moderate to severe pain.

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15
Q

This is about 2x as potent as morphine, used in patients tolerant to opioids.

A

Oxycodone

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16
Q

Semisynthetic derivative of morphine.

A

Oxycodone

17
Q

Synthetic opioid structurally UNRELATED to morphine

A

Meperidine (Demerol)

18
Q

Why is Meperidine NOT recommended for long-term pain?

A

It has active metabolic toxic metabolites (normeperidine) which have neurotoxic properties.

19
Q

In addition to common adverse reactions of opioids, what other SEs are associated with Meperidine?

A
  • anxiety
  • tremors
  • muscle twitches
  • anticholinergic effects
  • PUPIL DILATION
  • hyperactive reflexes
20
Q

What is unique about the extra SEs caused by Meperidine?

A

They cannot be reversed with the administration of naloxone.

21
Q

This centrally-acting opioid weakly inhibits reuptake of norepinephrine and serotonin, in addition to binding to the mu receptors

A

Tramadol (ultram)

22
Q

What type of pain is tramadol used for?

A

moderate to moderately severe pain

23
Q

This can cause toxicity when combined with TCAs and SSRIs, possibly leading to serotonin syndrome.

A

Tramadol

24
Q

This synthetic opioid is good for both nociceptive and neurogenic pain; works well for chronic pain

A

Methadone

25
Q

In addition to common adverse reactions of opioids, what other SEs are associated with Methadone?

A
  • Cardiac arrhythmias
  • Torsades de pointes
  • Cardiac arrest!
26
Q

This is well-absorbed orally and has a longer duration of action than morphine.

A

Methadone

27
Q

Fentanyl is a centrally-acting opioid that weakly inhibits reuptake of norepinephrine and serotonin, in addition to binding to the mu receptors. What are the differences between this and Tramadol?

A
  • It is a STRONG agonist
  • It has a RAPID ONSET and SHORT DURATION (but may take 48hrs to reach steady state)
  • May require a break-through drug
28
Q

Used to induce anesthesia and for analgesia during labor (epidural).

A

Fentanyl (Duragesic)

29
Q

Fentanyl (Duragesic) is used for patients with this type of pain.

A

Fluctuating pain levels (*esp for pts that can’t tolerate oral admin)

30
Q

What is one of the most common SEs of Hydromorphone (Dilaudid)?

A

Vomiting

CLIN MED Surgery (12 decks)

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