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Pharm Test 2 > Chapter 10 Analgesic Drugs > Flashcards

Chapter 10 Analgesic Drugs Flashcards

1
Q

Opioid Drugs

A

Synthetic drugs that bind to the opiate receptors to relieve pain

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2
Q

Opiod drug mild antagonists

A

codeine, hydrocodone

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3
Q

Opiod drug strong antagonists

A

morphine, hydromorphone, oxycodone, oxymorphone, meperidine, fentanyl, and methadone

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4
Q

Meperidine

A

not recommended for long-term use because of the accumulation of a neurotoxic metabolite, normeperidine, which can cause seizures

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5
Q

Opioid Ceiling Effect

A

-Drug reaches a maximum analgesic effect
-Analgesia does not improve, even with higher doses
Pentazocine
Nalbuphine

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6
Q

Agonists

A
  • Bind to an opioid pain receptor in the brain

- Cause an analgesic response (reduction of pain sensation)

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7
Q

Agonists-Antagonists

A
  • Bind to a pain receptor
  • Cause a weaker neurologic response than a full agonist
  • Also called partial agonist or mixed agonist
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8
Q

Antagonists

A
  • Reverse the effects of these drugs on pain receptors
  • Bind to a pain receptor and exert no response
  • Also known as competitive antagonists
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9
Q

Opioid Analgesics Main Use

A
  • to alleviate moderate to severe pain

- Often given with adjuvant analgesic drugs to assist primary drugs with pain relief

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10
Q

Opiods are also used for

A
  • Cough center suppression
  • Treatment of diarrhea
  • Balanced anesthesia
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11
Q

Opioid Analgesics: Contraindications

Use with extreme caution in patients with:

A
  • Respiratory insufficiency
  • Elevated intracranial pressure
  • Morbid obesity or sleep apnea
  • Paralytic ileus
  • Pregnancy
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12
Q

Opioid Analgesics: Adverse Effects

A 
CNS depression
Leads to respiratory depression
Most serious adverse effect
Nausea and vomiting
Urinary retention
Diaphoresis and flushing
Pupil constriction (miosis)
Constipation 
Itching
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13
Q

Opioids: Opioid Tolerance

A
  • A common physiologic result of chronic opioid treatment

- Result: larger dose is required to maintain the same level of analgesia

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14
Q

Opioids: Physical Dependence

A
  • Physiologic adaptation of the body to the presence of an opioid
  • Opioid tolerance and physical dependence are expected with long-term opioid treatment and should not be confused with psychologic dependence (addiction)
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15
Q

Opioids: Psychologic Dependence

A

A pattern of compulsive drug use characterized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief

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16
Q

Opioid Analgesics: Interactions

A
  • Alcohol
  • Antihistamines
  • Barbiturates
  • Benzodiazepines
  • Monoamine oxidase inhibitors
  • Others
17
Q

Codeine Sulfate

A
  • Natural opiate alkaloid (Schedule II) obtained from opium
  • Less effective
  • Ceiling effect
  • More commonly used as an antitussive drug
  • GI disturbance
18
Q

Fentanyl

A
  • Synthetic opioid (Schedule II) used to treat moderate to severe pain
  • Fentanyl in a dose of 0.1 mg intravenously is roughly equivalent to 10 mg of morphine intravenously
19
Q

Dilaudid

A

Hydromorphone (Dilaudid): very potent opioid analgesic; Schedule II drug
One milligram of IV or IM hydromorphone is equivalent to 7 mg of morphine

20
Q

Methadone Hydrochloride (Dolophine)

A
  • Synthetic opioid analgesic (Schedule II)
  • Opioid of choice for the detoxification treatment of opioid addicts in methadone maintenance programs
  • Renewed interest in the use of methadone for chronic (e.g., neuropathic) and cancer-related pain
  • Prolonged half-life of the drug: cause of unintentional overdoses and deaths
  • Cardiac dysrhythmias
21
Q

Morphine Sulfate

A
  • Naturally occurring alkaloid derived from the opium poppy
  • Drug prototype for all opioid drugs; Schedule II controlled substance
  • Indication: severe pain
  • High abuse potential
  • Oral, injectable, and rectal dosage forms; also extended-release forms
22
Q

Naloxone Hydrochloride (Narcan)

A
  • Pure opioid antagonist
  • Drug of choice for the complete or partial reversal of opioid-induced respiratory depression
  • Indicated in cases of suspected acute opioid overdose
  • Failure of the drug to significantly reverse the effects of the presumed opioid overdose indicates that the condition may not be related to opioid overdose.
23
Q

Opioid Analgesics:Nursing Implications

A
  • Withhold dose and contact physician if there is a decline in the patient’s condition or if vital signs are abnormal, especially if respiratory rate is less than 10 to 12 breaths/min.
  • Constipation is a common adverse effect and may be prevented with adequate fluid and fiber intake.

Pharm Test 2 (8 decks)

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