Analgesic: Opiods

Question 1

List 2 type of pain.

Answer 1

• Nociceptive

- Neuropathic

Question 2

Nociceptive

Answer 2

from tissue damage

Info to CNS by nociceptive pathway

Question 3

Nociceptive (Chemical mediators)

Answer 3

• Prostagladins
• Bradykinin
• Serotonin
• Histamine
• Acetylcholine
• Potassium

Question 4

Pain physiology?

Answer 4

Transduction -electrical energy send impulse to nociceptor
Transmission - A & C fiber
Perception - brain identify location
Modulation - inhibit pain impulse, endogenous opoids (MAIN!!!) hinder pain

Question 5

Type of nociceptive pain?

Answer 5

Somatic - cutaneous/deep tissue, Burn/arthritis
Visceral - Body organ/cavity, Referred pain, MI/kidney stone
can be acute/chronic

Question 6

What is Neuropathic Pain?

Answer 6

Nerve damage @PNS/CNS

DM foot, saraf sepit

Question 7

Analgesic deifinition?

Answer 7

Inhibit perception(sensation) of pain
-W/O blocking conduction nerve impulse

Question 8

Type of opioid analgesic?

Answer 8

Agonist & antagonist

Question 9

Opioid analgesic?

Answer 9

• opioid receptor
• Endogenous opoids
• Act in CNS
• Narcosis (stupor)
• Treat Visceral / severe pain !!!!!!

Question 10

MOA opioid?

Answer 10

Bind with opioid receptors
4 type receptor?
-Mu, delta, kappa, sigma
Inhibit transmission of nociceptove impulses

Question 11

Morphine is?

Answer 11

Major analgesic drug

Question 12

Indication of morphine?

Answer 12

• Relief pain
• relief distress
• tx insomnia, fear, anxiety
• diarrhea

Question 13

Pharmacology action of Morphine (CNS)?

Answer 13

• Analgesic
• Sedation
• Euphoria/dysphoria
• Depression (Respi, cough center, temperature regulating centre & vasomotor)
• Miosis
• Nausea vomit
• Neuro endocrine (decrease sex hormone/corticosteroids, Oliguria)
• CVS (vasodilate, cardiac work reduction)
• Smooth muscle (urine urgency, Bronchospasm)

Question 14

Opioid agonist-antagonist?

Answer 14

• tx moderate to severe pain

- Eliminate withdrawal symptoms

Question 15

Opioid antagonists

Answer 15

Block opioid receptor

Control withdrawal

Question 16

Nursing consideration?

Answer 16

1. ) Monitor pt vital sign and GCS. If noted that respration is <10/min, assess level of sedation. Physical stimulation maybe sufficient to prevent significant hypoventilation. Subsequence dose may need to decrease by 25% - 50%. Initial drowsiness will diminish with continue use.
2. ) Opioid may decrease the pt cough reflex. Encourage regular turning, cough and deep breathing exercise regularly to prevent atelectasis.
3. ) Administer opioid drug at least 30-60 min prior painful procedure to avoid or reduce the pain during the procedure in order to continue the procedure as patient tolerated.
4. )Monitor pt I&O as opioids may cause urinary retention
5. ) Provide safety precaution, put the risk of fall sign and make sure the side rail is up to ensure pat safety as morphine can cause drowsiness.
6. ) Monitor the withdrawal symptom, inform Dr to give agoist-antagonist to reduce the withdrawal symptom.
7. ) Monitor the adverse effect, inform Dr to prescribe antagonist to reduce the side effect.