Narcotic Pain Medications Flashcards
Break-through Pain
Episodic bursts of intense pain that breaks through pain mangagement regimens
Ceiling effect
Phenominon that patients experience limiting the ability to produce further relief above a particular dosage level
Nociceptors
Nerve endings that selectively respond to painful stimuli which send pain signals to spinal cord and brain
Patient-Controlled Analgesia (PCA)
Method used by patients to control the administration of their pain meds through a pump
Always programmed with 2 people
Pain Scales
Mild: rated 1-3
Moderate: rated 4-6
Severe: rated 7-10
FLACC scale
used for infants/nonverbal people
face, legs, activity, cry, and consolability
Wrong-Baker Scale
For children; Match the face on the print out to what they are feeling
Narcotic/Opioids
Agonists that activate opioid receptors in the CNS and PNS
Common Opioid Agonists
Morphine: prototype
Codeine: Mild to moderately sever pain, usually with tylenol (liquid)
Fentanyl: Severe pain
Hydrocodone: Moderate pain, used with acetaminophen
Percocet: Moderate to severe pain; oxycodone with acetaminophen
Oxycodone: Moderate to sever pain; Immediate release or extended release
Narcotic Indications
Moderate to severe pain, acute or surgery (pre&post), Chronic pain (cancer)
Narcotic Mechanism of Action
Inhibit pain signal transmission from periphery to brain, bind to receptors in CNS and alter perception of pain
Narcotic Pharmacokinetics
Absorption: peak time- Oral 1-2 hours, IM 30-60 min, SubQ 30-90 min, IV 8-20 min
Metabolism: Liver
Excretion: Kidney (urine)
Narcotic Adverse Effects
CNS: analgesia, CNS depression, respiratory depression, N/V, decreased mental and physical activity
GI: N/V, decreased motility, constipation, bowel and biliary spasms
GU: Urinary retention/hesitancy, decrease libido
Opioid Overdose Triad
Coma, pinpoint pupils, respiratory depression
All Narcs come with black box warning
Narcotic Drug-Drug interactions
Anti-anxieties, anti-psychotics,anti-depressants, antihistamines, any CNS depressant will have additive effects, Alcohol
Narcotic Contraindications
COPD, chronic lung diseases, liver or kidney disease, decrease GI motility, diarrhea caused by toxen, head trauma, GI/GU surgery
Narcotic Patient Education
take exactly as prescribed, PRN or routine, variable amounts, when to medicate (prior to painful activities), withdrawal s/s
Opioid Antagonists
Naloxone or Narcan: Reverses opioid overdoses; over the counter availability
Narcan Mechanism of Action
Blocks opioid receptors in the brain; displaces bound opioids
Narcan Pharmacokinetics
IV- 2 min, IM- 5 min, Nasal- 10 min
Duration of action: 30-50 min; requires repeat doses
Metabolism: liver
Narcan Adverse Effects
Tachycardia, Tachypnea (release of adrenaline), arrhythmias, opioid withdrawal symptoms
Narcan Patient Education
What Narcan does, what to pay attention to
