Narcotic analgesics Flashcards
opiate definition + examples
natural –> morphine, codiene
opioid definition
synthetic/semi-synthetic
narcotic drug used as prototype for dose conversions
morphine
most potent to least potent narcotic analgesics
fentanyl > hydromorphone, cod- > morphine > metripidine
narcotic antagonist names
naloxone, naltroxene, naloxegel
naloxone uses + ROA
reverses effects of severe opioid toxicity, not PO
naltroxene uses
treatment of alcohol withdrawal + opioid use disorder
naloxegel uses
opioid induced constipation
PDMPs function
track every CDS prescription dispensed by any outpatient pharmacy, required in all states
how often do pharmacists update NJ-PDMP?
biweekly
REMS focuses on what kinds of opioids?
ER
DEA function
oversee all CDS, enforced controlled substance laws
prescription blank narcotic rules
includes DEA + NPI# of prescriber + serial # of blank, limited to 1 CDS per script
telephone/e-script narcotic rules
no telephone orders, e-scripts allowed
post-dated CIIs common if >__ day narcotic supply
30
narcotic limit rules
30 days from DOI for Rx to be valid
max. 4x a day for 30 days (120 units)
narcotic refill rules
CII: no refills
CIII-CV: 5 refills within 6 months of DOI
narcotic partial filling rules
remainder of Rx must be filled within 72 hrs
CDS prescription label requirements
DOI
patient name + address
MD name + address + DEA #
drug name, strength, dosage form
quantity prescribed
# of refills
prescriber signature
CDS labeling requirements
pharmacy name + address
Rx serial #
date of fill + DOI
patient name
MD name
directions of use
refill info
cautionary label
narcotic analgesic names
-orph-, -cod-, -fent-, -adol, -nal, meperidine, methadone
narcotic analgesic MOA
narcotic agonist
narcotic analgesic effects
analgesic, euphoria/dysphoria, respiratory depression, dependence, sedation, miosis, decreased GI motility
narcotic analgesic indications
acute pain (IR), chronic pain (ER)
narcotic analgesic BBW
hypoventilation, abuse/addiction, not for children, ER formulations, abrupt treatment effects, chronic pregnancy use, avoid splitting
narcotic analgesic DDI
benzodiazepines, alcohol, barbiturates, MAOIs –> increased respiratory depression
enzyme inducer/inhibitor (clarithromycin, ketoconazole, linezoid, diltiazem, verapamil)
narcotic analgesic ADEs
pregnancy category C, somnolence
narcotic analgesic contraindications
respiratory depression, bronchial asthma, convulsive disorders, addiction-prone, treatment of diarrhea
