Analgesics

Question 1

what are the narcotic antagonists

Answer 1

naloxone (narcotics)

naltrexone (PO narcotics and alcohol)

Question 2

how do narcotic antagonists work

Answer 2

bind to opioid receptors to block and reverse opioid effects

Question 3

when to use narcotic antagonists

Answer 3

to reverse adverse narcotic effects

TX narcotic and alcohol dependence

Question 4

contra/cautions of narcotic antagonists

Answer 4

allergy
pregnancy and lact
narcotic addiction
CV disease

Question 5

what are the adverse effects of narcotic antagonists

Answer 5

acute narcotic abstinence syndrome/withdrawal
GI: N/V/D
CV: tachycardia, BP changes and dysrhythmias
sweating

Question 6

what are the drug-drug of narcotic antagonists

Answer 6

need larger doses for:

buprenorphine, butorphanol, nalbuphine, pentazocine, propoxyphene

Question 7

what are nursing considerations for narcotic antagonists

Answer 7

obtain a fast HX
obtain vitals, resp, BP/pulse and EKG
will have rapid withdrawl
have O2 supplementation on standby
for naltrexone must be narcotic free for 7-10days prior to admin
fall risk

Question 8

what are the narcotic agonist-antagonists

Answer 8

buprenorphine
butorphanol
nalbuphine
pentazocine

Question 9

how do narcotic agonist-antagonists work

Answer 9

they act at specific opiod receptors in the CNS

produce analgesia, sedation, euphoria, hallucinations

Question 10

when to use narcotic agonist-antagonists

Answer 10

moderate to severe pain
adjunct to anesthesia
relief of pain during labor and delivery

Question 11

contra/cautions of narcotic agonist-antagonists

Answer 11

allergy
nalbuphine (sulfite allergy)
physical dependence
COPD/disease of respiratory tract
acute MI or CAD
rena/hepatic dysfunction
pregnancy and lact

Question 12

adverse effects of narcotic agonist-antagonists

Answer 12

respiratory depression
GI: N/V, constipation, biliary spasms
CNS: HA, dizzy, psychoses, anxiety, hallucinations
GU: ureteral spasm and retention
sweating and dependence

Question 13

drug-drug for narcotic agonist-antagonists

Answer 13

barbituate, general anesthesia, narcotics: respiratory depression and increase in adverse effects

Question 14

nursing considerations for narcotic agonist-antagonists

Answer 14

pain assessments frequently
pupil size, baselines, ECG and respiratory
narcotic antagonist and ventilation on standby
monitor pain levels for easy dosing
provide additional pain measures
fall risk prevention and safety

Question 15

what are our narcotics

Answer 15

morphine
hydromorphone
codeine
oxycodone
fentanyl
hydrocodone

Question 16

how do narcotics work

Answer 16

act on specific opiod receptors in the CNS

produce analgesia, sedation and euphoria

Question 17

when to use narcotics

Answer 17

relief of severe to chronic pain
analgesia during anesthesia
labor and delivery

Question 18

contra/cautions of narcotics

Answer 18

allergy
diarrhea R/T poison
respiratory/liver/renal dysfunction
pregnancy and labor
GI/GU SX
acute abdominal ulcerative colitis
head injury, alcoholism, delirium tremens, CVA/stroke

Question 19

adverse effects of narcotics

Answer 19

dizziness, sedation
respiratory depression w/ apnea
cardiac arrest/shock and hypotension
GI: N/V, constipation
orthostatic hypotension

Question 20

drug-drug for narcotics

Answer 20

barbituate general anesthesia and phenothiazines: respiratory depression

MAIOs: serotonin syndrome

Question 21

nursing considerations for narcotics

Answer 21

pain assessments frequently
pupil size, baselines, ECG and respiratory
narcotic antagonist and ventilation on standby
monitor pain levels for easy dosing
provide additional pain measures
fall risk prevention and safety