Chapter 26

Question 1

Addiction

Answer 1

Psychological need / craving

Question 2

Withdrawal

Answer 2

Autonomic nerve response to acute discontinuation
Physical response

Question 3

Opioid receptors

Answer 3

CNS
Nerve in the periphery
Call in the GI tract

Question 4

Narcotic Agonists

Answer 4

Drug that interact with opioid receptors
Cause analgesia, sedation, euphoria
Potential for physical dependence
Controlled substances

Question 5

Narcotic Agonists: Generic drugs

Answer 5

Fentanyl - patches typically
Codeine - coughs or respiratory conditions (antitussive effects)
Morphine - non ceiling drug, dose can be increased
Methadone - synthetic opioid
Tramadol - Rx strength motrin
Hydromorphone
Oxycodone

Question 6

Narcotic Agonists: Actions & Indications

Answer 6

Actions: act at specific opioid receptor sites in the CNS, produces analgesia, sedation, sense of well being

Indications: relief of severe acute or chronic pain, analgesia during anesthesia, cross placenta

Question 7

Narcotic Agonists: Pharmacokinetics

Answer 7

IV most reliable way
Metabolized in liver and generally excreted in urine and bile

Question 8

Narcotic Agonists: Contraindications and Cautions

Answer 8

Allergies
Pregnancy, labor, lactation
Diarrhea caused by poisons

Question 9

Narcotic Agonists: Administration before and after

Answer 9

Before: pain intensity, last dose, respiratory status, SpO2, Dose/Drug

After: Amount of relief, respiratory status, SpO2

Question 10

Narcotic Agonists: Side Effects and Adverse Effects

Answer 10

Side: constipation, nausea/vomiting, drowsiness

Adverse: respiratory depression, addiction, dependence, withdrawal

Question 11

Narcotic Agonists: Drug to Drug interaction

Answer 11

Barbiturates
MAOIs

Question 12

Narcotic Agonists: Patient Teaching

Answer 12

Take with food, dont drive / operate machinery, change positions slowly, use caution with head injuries
Address constipation with patient using fluids / fiber/ ambulation

Question 13

Narcotic Antagonists: Actions & Indications

Answer 13

Actions: binds to opioids receptor but do not activate it, reverses the effects of opioids

Indications: reversal of adverse effects of narcotics, treat narcotic and/or alcoholic dependence

Question 14

Narcotic Antagonists: Pharmacokinetics

Answer 14

Well absorbed after injection and widely distributed in the body

Metabolized in the liver, excreted in the urine

Enter breast milk

Question 15

Narcotic Antagonists: Contraindications

Answer 15

Allergies

Question 16

Narcotic Antagonists: Generic Names

Answer 16

Naloxone - reverses adverse effect of narcotics, suspected acute narcotic overdoses

Naltrexone - used orally in management of alcohol or narcotic dependence

Question 17

Narcotic Antagonists: Adverse Effects

Answer 17

tachycardia, blood pressure changes, dysrhythmias, pulmonary edema