[Exam 1] Module 11 - Drug Therapy for Pain Flashcards
1
Q
What are the three opoid receptors?
A
Mu, kappa, delta
2
Q
Information about Mu receptor
A
Stimulated by opioid drugs.
They cause analgesia, or relief of pain.
Stimulation causes respiratory depression, euphoria, sedation.
3
Q
Information about Kappa receptors.
A
Stimulated by opioid drugs.
Cause analgesia , sedation.
4
Q
What are the for type of nonopioid analgesics that treat pain?
A
1st Gen NSAIDs (COx-1 and Cox-2 Inhibitors)
2nd Gen NSAIDs (Cox-2 Inhibitors)
Acetaminophen (Tylenol)
TRamadol (Ultram)
5
Q
1st Gen NSAIDS: What do they do?
A
Supress inflammation, treat mild to moderate pain, reduce feveer and relieve dysmenorrhea.
6
Q
1st Gen NSAIDS: Aspirin also inhibits
A
Platelet aggregation, making effective option for anticoagulant.
7
Q
1st Gen NSAIDS: Often give aspirin when
A
prophylactic or long term treatment against the development of thrombi is needed
8
Q
1st Gen NSAIDS - Prototype
A
Aspirin (ASA)
Ibuprofen (Advil and Motrin)
Naproxen (NAprosyn and Aleve)
Ketorolac
9
Q
1st Gen NSAIDS - Expected Pharmacologic Action: NSAIDS inhibit the action of
A
Cyclooxygenase or COX. This is an enzyme that converts arachidonic acid into prostaglandins when tissue injury cocurs.
10
Q
1st Gen NSAIDS - Expected Pharmacologic Action: Release of COX 1 enzyme stimulates
A
release of prostaglandins that work to maintain homeostasis in the body .
11
Q
1st Gen NSAIDS - Expected Pharmacologic Action: Cox 1 acts to protect
A
gastric mucosa, enhance platelet aggregation, and promote renal function.
12
Q
1st Gen NSAIDS - Expected Pharmacologic Action: COX -2 enzyme stimulates release of
A
prostaglandins in response to injury, which results in inflammation, pain, and fever
13
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Gastric Mucosa of COX-1 Stimulated?
A
Gastric mucosa protected, when decrease production of stomach acid
14
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Gastric Mucosa if COX-1 Inhibited?
A
Gastric mucosa not protected, ulcer development
15
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Platelet Aggregation if COX-1 Stimulated?
A
Enhances platelet aggregation
16
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Platelet Aggregation if COX-1 Suppressed?
A
Decreases platelet aggregation and anticoagulant effects- (bleeding, bruising)
17
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to kidneys if COX-1 Stimulated?
A
Promote kdiney perfusion
18
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to kidneys if COX-1 Inhibited?
A
Impairs renal perfusion - decreased urine output, and increased BUN and creatinine
19
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Inflammation if COX-2 Stimulated?
A
Promotes inflammation
20
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Inflammation if COX-2 Inhibited?
A
Decreases inflammation
21
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Pain if COX-2 Stimulated?
A
Causes pain
22
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Pain if COX-2 Inhibited?
A
Decreases pain
23
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Body Temperature if COX-2 Stimulated?
A
Increases body temperature
24
Q
1st Gen NSAIDS - Expected Pharmacologic Action: What happens to Tissue Injury/Body Temperature if COX-2 Inhibited?
A
Decreases body temperature
25
1st Gen NSAIDS - Adverse Drug REactions: This related to the inhibition of protective effects of COX-1. This includes
Gastric upset, heartburn, nausea, and gastric ulceration.
26
1st Gen NSAIDS - Adverse Drug REactions: Renal dysfunction is an adverse drug reaction because
NSAIDs block the protective effective of COX-1 on kidneys.
27
1st Gen NSAIDS - Adverse Drug REactions: Increased risk for thromboembolic events exists when
clients take a non-aspirin NSAID
28
1st Gen NSAIDS - Adverse Drug REactions: Salicylism can occur, which is
buildup of Aspirin in the body to toxic levels.
29
1st Gen NSAIDS - Adverse Drug REactions: Reyes Syndrome, which is
serious disorder that has occured secondary to giving aspirin to a child who has viral infection.
30
1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Reye's syndrome m anifests with
vomiting, confusion, seizures, and loss of consciousness.
31
1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Reyes Syndrome Can occur secondary to
metabolic conditio or when you give aspirin to an infant child who have viral infection, like influenza or chickenpox
32
1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Reyes Syndrome can cause
liver and brain damage and even death
33
1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Early Diagnosis and Treatment for Reye's Syndrome includes
Diuretics and electrolytes to prevent swelling.
34
1st Gen NSAIDS - Adverse Drug REactions (Safety Alert): Know to avoid giving children aspirin or NSAID for
fever secondary to a viral infection
Acetaminophen is safe for administration
35
1st Gen NSAIDS - Interventions: Monitor for signs of
Bleeding, including black or dark-colored stools, abdominal pain, nausea, and hematemesis.
Bruising, Petechiae, and excessive bleeding from minor injuried.
36
1st Gen NSAIDS - Interventions: Test and Treat for
H. Pylori
37
1st Gen NSAIDS - Interventions: For clients at risk for gastric bleeding, what should they receieve during therapy?
PPI concurrently
38
1st Gen NSAIDS - Interventions: Monitor what from kidneys?
I/O, BUN, and Creatinine which reflect decreased kidney function
39
1st Gen NSAIDS - Interventions: To prevent REye's Syndrome in children anda dolescents who have viral infections, use
acetaminophen, also called Tylenol instead of Aspirin or NSAIDs
40
1st Gen NSAIDS - Interventions: When NSAID therapy is necessary, recommend using what?
Non-Aspirin NSAIDs for short poeriods of time and in low doses to help minimize adverse drug reactions
41
1st Gen NSAIDS - Interventions: If provider prescribes COX-1 and COX-2 inhibiting NSAID for long-term therapy, make sure they also provide
low-dose aspirin toprevent embolic event
42
1st Gen NSAIDS - Administration: How do clients take this?
Make sure they swllow enteric-coated or sustained-release forms whole and do not crush or chew them.
43
1st Gen NSAIDS - Administration: When would discontinue aspirin before surgery?
Aspirin, due to their effects on platelet aggregation and bleeding
44
1st Gen NSAIDS - Administration: Epect aspirin dose to be what when giving prophylactically
81 mg to inhibit platelet aggregation
45
1st Gen NSAIDS - Client Instructions: Tell clients to take with
food, milk, or 8 oz of water to minimize GI Effects
Avoid alcohol
46
1st Gen NSAIDS - Client Instructions: CLient should report
persisitent gastric irritation and signs of bleeding, such as easy bruising or prolonged bleeding as well as weight changes.
47
1st Gen NSAIDS - Client Instructions: Avoid giving aspirin or NSAIDs to those under 18 who have
viral infection, use acetaminophen instead
48
1st Gen NSAIDS - Client Instructions: Due to risk of development of thrombi when taking non-aspirin NSAID, immediately report to provider what signs?
Chest pain, shortness of breath, headache, one sided numbness.
49
1st Gen NSAIDS - Client Instructions: Reinforce that the use of low-dose aspirin once daily reduces
risk of myocardial infarction and cererovascular accident
50
1st Gen NSAIDS - Client Instructions: First sign of Salicylism?
Ringing or buzzing in the ears. , along with sweating, headache, and dizziness
51
1st Gen NSAIDS - Client Instructions (Safety Alert): What is Salicylism?
Name for Aspirin Toxicity. Can happen with clients who take drug regularly for chronic condition such as RA.
52
1st Gen NSAIDS - Client Instructions (Safety Alert - Salicylism): Important to know what symptoms indicate that toxicity is beginning to develop such as
Decreased hearing and tinnitus, Headache, and Dizziness.
If drug continues to be taken, will experience N/V, Diarrhea, and Diaphoresis.
IF continued...
Fever, Confusion, Seizure, and REspiration failure can occur
53
1st Gen NSAIDS - Contraindications: Is this a Teratogenic drug?
Yes
54
1st Gen NSAIDS - Contraindications: What should those with peptic ulcer disease or bleeding disorder do?
Avoid taking thi sdug.
55
1st Gen NSAIDS - Contraindications: Non-Aspirin NSAIDs contraindication in those who have
hypertension
56
1st Gen NSAIDS - Interactions: What other uses increase the clients risk of bleeding?
Use of aspirin along with anticoagulants, glucocorticoids and alcohol
57
1st Gen NSAIDS - Interactions: What does Ibuprofen do to aspirin?
DEcreases anti-okatlet effects of low - dose aspirin
58
1st Gen NSAIDS - Interactions: Use of Aspirin with ACE Inhibitorsnd ARB causes
risk of renal failure as well as decrease anti-hypertensive effects of ACE Inhibitors
59
1st Gen NSAIDS - Interactions: 1st Gen NSAIDS - Interactions: Risk of toxicity increases with us eof what drugs?
Lithium Carbonate (Eskalith)
Methotrexate (Rheumatrex)
60
2nd Gen NSAIDS (Cox-2 Inhibitors): What are these?
Treat mild to moderate pain.
Also suppresss inflammation, reduces fever adn treat pain of dysmenorrhea
61
2nd Gen NSAIDS (Cox-2 Inhibitors): Prototype
Celecoxib (CElebrex)
62
2nd Gen NSAIDS (Cox-2 Inhibitors): Celecoxib is the only true
COX-2 Inhibitor sitll on the market.
63
2nd Gen NSAIDS (Cox-2 Inhibitors) - Expected Pharmacologic Action: DEveloped in hope that drug reactions related to COx-1 would be ... including
minimized
This includes effects on stomach, kidney, and platelets
64
2nd Gen NSAIDS (Cox-2 Inhibitors) - Adverse Drug REactions: This includes
Gastric upset, diarrhea, heartburn, nausea, and gastric ulceration. Less of a probblem than with COX-1.
65
2nd Gen NSAIDS (Cox-2 Inhibitors) - Adverse Drug REactions: What can still occur with clients who take COX-2 Inhibiting NSAID?
Renal dysfunction, cardiovascular, and ceebrovacular events
66
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: Monitor for
Gastric Upset, heartburn, Nausea, Diarrhea and GI Bleeding
I/O, BUN, Creatinine.
67
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: Important to treaat what prior to long-term NSAID therapy?
H. Pylori
68
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: For those at risk for gastric bleeding, what else should be taken?
PPI Inhibitor
69
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: What should the provider recommend to minimize drug reactions?
Use for short periods of time in low doses
70
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: Monitor for signs of
MI and Cerebrovacular accident due to thromboembolic events
71
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interventions: If giving Celecoxib for long term therapy, why is aspirin recommended?
TO prevent those thromboembolic events
72
2nd Gen NSAIDS (Cox-2 Inhibitors) - Administration: When should you give it?
Give 2 hours before or after Mg or Aluminum based antacids.
73
2nd Gen NSAIDS (Cox-2 Inhibitors) - Client Instructions: When providing instruction for clients on long-term NSAID terapy, reinforce use o f
low-dose aspirin once daily to reduce risk of heart attacak adn stroke.
74
2nd Gen NSAIDS (Cox-2 Inhibitors) - Client Instructions: Take this drug with
food, milk, or 8 oz of water and to avoid alcohol
75
2nd Gen NSAIDS (Cox-2 Inhibitors) - Client Instructions: Report what to provider?
Persistent gastric irritation adn signs of GI Bleeding , as well as i/o, weight gain, or fluid retentionn.
76
2nd Gen NSAIDS (Cox-2 Inhibitors) - Contraindications and Precautions: Is this a Teratogenic drug?
Yes, during third semester
77
2nd Gen NSAIDS (Cox-2 Inhibitors) - Contraindications and Precautions: Contraindicated in those who have
severe kidney impairment, children younger than 18, clietns with GI bleeding, and allergy to celecoxib, sulfa, or sulfonamides.
78
2nd Gen NSAIDS (Cox-2 Inhibitors) - Contraindications and Precautions: Use in caution for those with
alcohol use disorder, HF, Cardiovascular didsease, diabetees, hypertension.
79
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: Interactis with Furosemide (Lasix) decreasing its
diuretic effects
80
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: Fluconzaole (Diflucan) can do what?
Increase celecoxib levels
81
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: THis does what to Warfarin?
Increases anticoagulant effects
82
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: Glucocorticoids and alcohol do what?
Increase risk of bleeding
83
2nd Gen NSAIDS (Cox-2 Inhibitors) - Interactions: ACE Inhibitors
Antihypertensive effects decrease
84
Acetaminophen: What is this?
Nonopoid Analgesic to treat mild to moderate pain and reduce fever
85
Acetaminophen - Prototype: Prototype?
Acetaminophen (Tylenol)
86
Acetaminophen - Prototype: How does this compare to COX-1 and COX-2 Inhibitors?
Same benfits without serious adverse drug reactions
87
Acetaminophen - Expected Pharmacologic Action: Acetaminophen is a
COX Inhibitor .. but effects limited to CNS
88
Acetaminophen - Expected Pharmacologic Action: Due to lack of peripheral inhibition, it has no
inflammatory or anticoagulant effects . Doesnt affect gastric mucosa or platelets, decreasing risk of gastric ulcers
89
Acetaminophen - Adverse Drug REactions: Limited to
liver damage when you give drug in toxic doses over long period of time and hypertension with daily use
90
Acetaminophen - Interventions: Monitor for early signs of
overdose or poisoning.
This includes abdominal discomfort, N/V, sweating, and diarrhe.
91
Acetaminophen - Interventions: Liver and when giving in toxic dosage?
Can occur in 48-72 hours
92
Acetaminophen - Interventions: What to give if overdose occurs?
Administer Acetylcysteine, also called Mucomyst and ACetadote.
93
Acetaminophen - Administration: Can give this how?
Orally or Rectally
94
Acetaminophen - Administration: Adult dosage?
4 g per day.
95
Acetaminophen - Administration: Toxic to liver when how much ingested?
4g/day.
96
Acetaminophen - Administration: Be weary of cold medicine because
they often contain acetaminophen as well
97
Acetaminophen - Client Instructions: Avoid going over how much of a dose?
4 gram per day.
98
Acetaminophen - Client Instructions: Instruct clients to report what sign s
abdominal discomfort, N/V, Sweating or diarrhea
99
Acetaminophen - Contraindications and Precautions: Who should not use this?
Those with alcoholism.
Use in caution for those with anemia, immune suppression and hepatic or renal disease.
100
Acetaminophen - Interactions: Alcohol increases risk of liver injury when it interacts with
high doses of acetaminophen
101
Acetaminophen - Interactions: Using this with warfarin increases risk of
bleeding
102
Acetaminophen - Interactions: Cholestyramine (Questran) reduces
absorption of acetaminophen
103
Centrally Acting Nonopioid: What is this?
Last group of nonopioid drugs to relieve pain . Treat moderate to moderately severe pain
104
Centrally Acting Nonopioid - Prototype:
Tramadol (Ultram)
105
Centrally Acting Nonopioid - Expected Pharmacologic Action: How doees this work?
Binds to selected opioid receptors and blocks reuptake of norepinephrine and serotonin in the CNS
106
Centrally Acting Nonopioid - Adverse Drug REactions: Rare but when they happen, they include
sedation adn dizziness as well as headache, nausea, and constipation
107
Centrally Acting Nonopioid - Adverse Drug REactions: Other considerations?
REspiratory depression rare, and seizures and urinary retention may occur
108
Centrally Acting Nonopioid - Interventions: Monitor them for
ambulation and offer support as necessary
109
Centrally Acting Nonopioid - Interventions: Dosage recommendation?
Lowest dose possible and for short term only
110
Centrally Acting Nonopioid - Interventions: What should you give drug with?
Food and antiemiec as needed for nausea
111
Centrally Acting Nonopioid - Interventions: What should you do if RR is below 12?
Stimualte breathing. Administer Opioid antagonist, such as Naloxone.
112
Centrally Acting Nonopioid - Administration: Will not feel effects until
one hour after administration.
113
Centrally Acting Nonopioid - Administration: How to take the medicine?
Make sure clients swallow the extended-relase form whole and do not chew or crush them
114
Centrally Acting Nonopioid - Client Instructions: Avoid take drug when?
Prior to driving or activites that require mental alertness. Sit or lie down if feeling lightheaded.
115
Centrally Acting Nonopioid - Client Instructions: To minimize risk of adverse drug reactions, encourage them to
take drug only when needed on a short term basis.
116
Centrally Acting Nonopioid - Contraindications and Precautions: Contraindicated in clients who are
intoxicated with alcohol, opioids or psychotropic drugs,
Have respiratory disorders or under age of 12.
117
Centrally Acting Nonopioid - Interactions: MAOIs?
Pose risk for a hypertensive crisis.
118
Centrally Acting Nonopioid - Interactions: Use with SNRI, Tricylic Antidepressants, MAOis and TRiptans pose risk for
serotonin syndrome
119
Centrally Acting Nonopioid - Interactions: ADministering with St Jogn wort dodes what?
Increases sedative effects
120
Opoid Agonists bind primarily to
Mu-Type Opioid receptors to produce their analgesic effects
121
OPioid agonist-antagonists bund to
mu and kappa receptors, stimulating and blocking their analgesic effects
122
Opoid Agonist-Antagonists are a good alernative to opioids for clients who are
addicted with opioids or women in labor
123
Opioid Agonists: Serve as
Analgesic for moderate to severe pain and may cause sedation and redce anxiety in preoperative
124
Opioid Agonists - Prototype
Morphine
Meperidine (Demerol)
Methadone (Dolophine)
Codeine
Oxycodone (Oxycontin)
125
Opioid Agonists - Expected Pharmacologic Action: Opioid agonists mimic that actions of
naturally occuring opioids, endophins, and enkephalins.
Do this by binding with mu receptors
126
Opioid Agonists - Expected Pharmacologic Action: Stimulation of mu receptors causes
analgesia, sedation, euphoria, and respiratory depression
127
Opioid Agonists - Adverse Drug REactions: What occurs secondary to stimulation of mu opioid receptors?
Respiratory depression and sedation
128
Opioid Agonists - Adverse Drug REactions: Effects that accompany sedation are
dizziness, lightheadness and drowsiness.
129
Opioid Agonists - Adverse Drug REactions: Common adverse drug reaction is
constipation, because they decrease intestinal motility
Along with N/V.
130
Opioid Agonists - Adverse Drug REactions: Opioid agonists dilating effects on peripheral vasculature causes
orthostatic hypotension
131
Opioid Agonists - Adverse Drug REactions: They cause what other problems?
Urinary retention, cough suppression, and euphoria.
132
Opioid Agonists - Interventions: Closely monitor
VS and Pulse Oximetry, and Auscutae lungs for congestion.
133
Opioid Agonists - Interventions: What to do if RR below 12?
Stimulate brething and administer opioid antagonist, such as Naloxone.
134
Opioid Agonists - Interventions: For vomiting, give this drug with
food and administer an antiemetic as needed
135
Opioid Agonists - Interventions: Why should you monitor I/O?
Watch for signs of urinary retention such as bladder distention. Encourage them to urinate every 4 hours.
136
Opioid Agonists - Interventions: TO prevent dependence, make sure providere prescribes
the lowest possible effective dose on a short-term basis
137
Opioid Agonists - Administration: What should you do before admiistration?
Obtain clients baseline vital signs.
138
Opioid Agonists - Administration: How can you give this?
Orally
Intramuscularly
Intravenously
subcutaneously
Rectally
Epidurally
139
Opioid Agonists - Administration: When giving over IV, how should you spread it out?
Give over 4-5 minutes
140
Opioid Agonists - Administration: What should you be aware of for those taking it for a long time?
Gradual withdrawal of drugs over period of several days.
141
Opioid Agonists - Client Instructions: Emphasize that they should take drug when
they needed it and on a short-term basis .
Don't take prior to driving or activiies requiring mental alertness.
142
Opioid Agonists - Contraindications and Precautions: Contraindicated in women who are
pregnant because morphone is a pregnancy risk .
143
Opioid Agonists - Contraindications and Precautions: Those with what system issues are contraindicate?
Those with renal failure, increased intracrnaial pressure, biliary colic, or biliary surgery.
144
Opioid Agonists - Interactions: They interact with what by increasing their CNS depressant effects?
CNS Depressants
145
Opioid Agonists - Interactions: Anticholinergic Agents
Anticholinergic effects increase causing constipation and urinary retention.
146
Opioid Agonists - Interactions: MAOIs cause
hyperpyrexic syndrome, which manifests as excitation, sizures, and highly elevated temperature
147
Opioid Agonists - Interactions: USe with anti-hypertensives increases
hypotensive effects
148
Opioid Agonists - Interactions: St. Johns Wort may increase
sedation
149
Opioid Agonists-Antagonists: Help relieve
moderate to severe pain, and act as an adjunct to anesthesia
150
Opioid Agonists-Antagonists - Prototype:
Butorphanol and Pentazocine (Talwin)
151
Opioid Agonists-Antagonists - Prototype: Butorphanol only available as
injectable or nasal spray
152
Opioid Agonists-Antagonists - Prototype: Pantazocine (With Naloxone) available in
oral form
153
Opioid Agonists-Antagonists - Expected Pharmacolgic Action:: What do they do to mu and kappa receptors?
Mu Receptor Antagonists
Kappa Receptor Agonists
154
Opioid Agonists-Antagonists - Expected Pharmacolgic Action:: These result in fewer mu-related adverse drug reactions such as
respiratory depression, euphoria, and dependnce
155
Opioid Agonists-Antagonists - Expected Pharmacolgic Action:: They can precipitate withdrawal in clients addicted to opiids so what may clients need to reveal?
Opioid use before administration
156
Opioid Agonists-Antagonists - Adverse Drug Reactions: Signs include
Limited Respiratory Depression, Sedation, Dizziness, And Lightheadedness, Drowsiness, Headache, and Nausea.
157
Opioid Agonists-Antagonists - Adverse Drug Reactions: These drugs affect
cardiac output.
158
Opioid Agonists-Antagonists - Interventions: When caring for client, ask them what before administering this drug?
About their opioid use
159
Opioid Agonists-Antagonists - Interventions: Monitor clients when ambulating if they experience
dizziness or lightheadedness and consider recommending an alternative drug if nausea does not resolve
160
Opioid Agonists-Antagonists - Interventions: Do not administer what to those with what medical problems?
Myocardial Infarction and CArdiac Insufficiency
161
Opioid Agonists-Antagonists - Administration: How can you administer this?
Intramuscualrly, Intravenously or Intranasally
162
Opioid Agonists-Antagonists - Administration: Pentazocina (Talwin) would be given orally when
invasive route is not warranted or clients tkane the drugs as part as home pain management
163
Opioid Agonists-Antagonists - Administration: For intranasal administration of butorphanol, you give
one spray into one nostril and repeat every 60-90 minutes as needed
164
Opioid Agonists-Antagonists - Client Instructions: Make sure clients know when to take drug?
Only when needed or on short-term basis
165
Opioid Agonists-Antagonists - Client Instructions: Dont take drug prior to
driving or activites that require mental alertness.
166
Opioid Agonists-Antagonists - Client Instructions: If dizziness experienced, remind them to
sit or lie down
167
Opioid Agonists-Antagonists - Client Instructions: Instruct cliients not to take these drugs for anginal pain due to their
effect on cardiac output
168
Opioid Agonists-Antagonists - Client Instructions: Emphaize they should not take what when taking opioid agonist antagonist
Opioids
169
Opioid Agonists-Antagonists - Contraindications and Precautions: Who should not take this?
Those who have acute MI or are dependent on opioids.
170
Opioid Agonists-Antagonists - Contraindications and Precautions: Take caution in clients who have
head i njury, increased intracranial pressure, reduced respiratory reserve or cardiac insufficiency
171
Opioid Agonists-Antagonists - Interactions: Dont give this with other
CNS DEpressants and alcohol because it will increase CNS depression and risk of respiratory depression.
172
Opioid Agonists-Antagonists - Interactions: This will decrease the effects of
opioids
173
Opioid Antagonits: Reverse the effects of
opioids and treat opioid overdsose
174
Opioid Antagonits: They reverse
the neonatal respiratory depression that can occur secondary to the mother receiving an opioid during labor
175
Opioid Antagonits: Prototype
Naloxone (Narcan)
176
Opioid Antagonits - Expected Pharmacologic Action: What are opioid antagonists?
An antagonist in the purest sense of the word.
Produce effects by blocking opioid receptors, effectively reversing or antagonizing effects of opioids
177
Opioid Antagonits, Naloxone - Adverse Drug Reactions: Most significant reaction is
Ventricular Arrythmias. Can expect the HR and RR to increase.
178
Opioid Antagonits, Naloxone - Adverse Drug Reactions: Abstinence Syndrome, also called withdrawal, may precipitate in clients who are
opioid dependent
179
Opioid Antagonits, Naloxone - Adverse Drug Reactions: Symptoms that include in opioid dependent clients include
hypertension, vomiting, tremors
180
Opioid Antagonits, Naloxone - Adverse Drug Reactions: If caring for client who overdoses on CNS depressant drug outside hospital ,you may not know if
client is physically dependent on opioids.
181
Opioid Antagonits, Naloxone - Adverse Drug Reactions: How much to administer for someone who overdoses?
Several small doses with a space of time in between injections in minimize withdrawal symptoms
182
Opioid Antagonits - Interventions: Closely monitor for
dangeous elevations in clients blood pressure.
183
Opioid Antagonits - Interventions: Monitor heart rhtym for signs of clients who are opioid dependent or have
respiratory depression
184
Opioid Antagonits - Interventions: Naloxone has no effects on drugs that are not
opioiods
185
Opioid Antagonits - Interventions: Use in cautions for clients who have
cardiac irritability, a head injury with increased intracranial pressure, brain tumor, or seizure disorder
186
Opioid Antagonits - Administration: You can administer this
Intramuscularly, Intravenously, or subcutaneously
187
Opioid Antagonits - Administration: If given IV, what should you do?
Titrate dose carefully. Monitor vital signs every 5-15 minutes and several hours after conclusion
188
Opioid Antagonits - Administration: Effects last
60-90 minutes , so respiratory depression can recur
189
Opioid Antagonits - Administration: Naloxone might increase
clients pain by blocking the analgesic effect of the opoid.
190
Opioid Antagonits - Administration: Prepare to admiister how?
Every 2-3 minutes until reversal of undesurable effect occurs
191
Opioid Antagonits - Administration: Observe for
N/V, Tachycardia, And Diaphoresis which accompanies opioid reversal
192
Opioid Antagonits - Client Instructions: When administering to someone who i sawake, inform them of
need for drug, possible adverse drug reactions, and return of pain
193
Opioid Antagonits - Conraindications and Precautions: Those who are opioid dependent or have respiratory depression due to nonopioid drugs should
not take naloxone.
194
Opioid Antagonits - Conraindications and Precautions: Use in caution with patients who have
cardiac irritability
Head injury
Increased intracranial pressure
brain tumor
Seizure disorder
195
Opioid Antagonits - Interactions: Decreease effects of
Opioids
