Exam One Review Sheet Flashcards
What are other drugs in the same class as Morphine
fentanyl hydromorphone (Dilaudid) levorphanol meperidine (Demerol) Methadone oxycodone (Percodan, Percocet)
Morphine is considered what kind of opioid?
Strong Narcotic Agonist
fentanyl is ______ times more potent than morphine.
80-100%
Mechanism of Action of morphine
- occupies mu and kappa in brain and dorsal horn of SC
- decreased release of neurotransmitters in presynaptic space
- Results in hyperpolarization of post synaptic dorsal horn neurons
- Prevent transmission of nociceptor pain
- Decreased relsear of substance P - modulates pain perception
Indications for morphine
Moderate to severe pain
Metabolism of morphine happens in the __________
Liver
Elimination of morphine is through the __________
Feces (PO)
Onset of morphine
15-30 minutes
Duration of morphine
3-7 hrs
Contraindications of morphine
Head injury patients (masks signs and symptoms)
Patients on other CNS depressants
Elderly may need dose reduction
Prostate patients due to urinary retention
Adverse Effects of morphine
CNS: Mood change, lethargy, delirium, euphoria, pupillary constriction
Respiratory: Decrease RR, Resp arrest, apnea
CV: hypotension, bradycardia, cardiac arrest, shock, coma
GI: N/V, constipation
GU: Urinary retention
Histamine: Itching and hives
Drug interactions with morphine
Hepatically cleared drugs: H2 Blockers, barbituates, warfarin
CNS depressants: ETOH
What type of opioid is codeine?
Mild Narcotic agent
What other drugs are in the same class as codeine?
hydrocodone (Vicodin)
Codeine is _____ as potent as morphine
1/6
Mechanism of action of codeine
Similar to morphine
acts on opioid receptors in CNS to prduce analgesia, euphoria, and sedation
Acts on medullary cough center to depress cough reflex
Drying effects on mucous membranes
Indications for codeine
Mild to moderate pain
Metabolism of codeine happens in the ________
Liver
Elimination of codeine happens in the __________
Kidneys
Onset of codeine
15-30 min
Duration of codeine
3-7 hours
Contraindications of codeine
Pre/post op patients who need to cough and deep breathe
CVA patients
Resp patients
Adverse effects of codeine
Similar to morphine Dry mouth Drowsiness Sedation Depress cough reflex
Drug interactions with codeine
Other CNS depressants
True or false: Codeine is safer for brain injury patients than morphine
True: Doesn’t depress the CNS as much or mask s/s of brain injury
What kind of opioid is pentazocine (Talwin)?
Narcotic Agonist
What other drugs are in the same class as pentazocine (Talwin)?
buprenophine (Bupranex)
butorphanol (Stadol)
nalbuphine (Nubain)
Mechanism of action of pentazocine (Talwin)
Mixed opioid effects
Agonist at some receptors and antagonist at other receptors
Get opioid effect without over doing it.
Indications for pentazocine (Talwin)
Moderate to severe pain
pentazocine (Talwin) is metabolized in the ________
Liver
pentazocine (Talwin) is eliminated through the _____
Kidneys
Onset of pentazocine (Talwin)
15-30 min
Duration of pentazocine (Talwin)
3-7 hours
Contraindications of pentazocine (Talwin)
Resp depression patients
Adverse effects of pentazocine (Talwin)
Withdrawl effects in unknown addicts Resp depression Circulatory depression N/V Dizziness Lightheadedness Euphoria
Drug interactions with pentazocine (Talwin)
Other CNS depressants
True or false: pentazocine (Talwin) is used in patients with hx of addiction
True