Analgesic: Opiods Flashcards
List 2 type of pain.
- Nociceptive
- Neuropathic
Nociceptive
from tissue damage
Info to CNS by nociceptive pathway
Nociceptive (Chemical mediators)
- Prostagladins
- Bradykinin
- Serotonin
- Histamine
- Acetylcholine
- Potassium
Pain physiology?
Transduction -electrical energy send impulse to nociceptor
Transmission - A & C fiber
Perception - brain identify location
Modulation - inhibit pain impulse, endogenous opoids (MAIN!!!) hinder pain
Type of nociceptive pain?
Somatic - cutaneous/deep tissue, Burn/arthritis
Visceral - Body organ/cavity, Referred pain, MI/kidney stone
can be acute/chronic
What is Neuropathic Pain?
Nerve damage @PNS/CNS
DM foot, saraf sepit
Analgesic deifinition?
Inhibit perception(sensation) of pain -W/O blocking conduction nerve impulse
Type of opioid analgesic?
Agonist & antagonist
Opioid analgesic?
- opioid receptor
- Endogenous opoids
- Act in CNS
- Narcosis (stupor)
- Treat Visceral / severe pain !!!!!!
MOA opioid?
Bind with opioid receptors
4 type receptor?
-Mu, delta, kappa, sigma
Inhibit transmission of nociceptove impulses
Morphine is?
Major analgesic drug
Indication of morphine?
- Relief pain
- relief distress
- tx insomnia, fear, anxiety
- diarrhea
Pharmacology action of Morphine (CNS)?
- 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)
Opioid agonist-antagonist?
- tx moderate to severe pain
- Eliminate withdrawal symptoms
Opioid antagonists
Block opioid receptor
Control withdrawal
Nursing consideration?
- ) 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.
- ) Opioid may decrease the pt cough reflex. Encourage regular turning, cough and deep breathing exercise regularly to prevent atelectasis.
- ) 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.
- )Monitor pt I&O as opioids may cause urinary retention
- ) 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.
- ) Monitor the withdrawal symptom, inform Dr to give agoist-antagonist to reduce the withdrawal symptom.
- ) Monitor the adverse effect, inform Dr to prescribe antagonist to reduce the side effect.
