Opiates

Question 1

What are the warning signs of opiates

Answer 1

Respiratory depression (difficulty breathing)

Bradycardia/hypotension (feeling faint, dizziness)

Extreme sleepiness

Reduced concentration or confusion (not able to think, walk or talk normally)

Cyanosis of lips, ears, nose

Vivid dreams, hallucinations or nightmares

Convulsions

Pinpoint pupils

Question 2

What is the dependence and tolerance of opiates symptoms

Answer 2

Psychological behaviours:
Craving
Compulsive Use
Continued use despite harm

Physical dependence or withdrawal symptoms:
Sweating
Restlessness
Tremor
Increase in normal pain
Diarrhoea
Nausea and vomiting
Anxiety

Question 3

What are the interactions with opiates

Answer 3

Enhanced hypotensive and sedative effects when given with alcohol

Tramadol enhances anti-coagulant effect of coumarins

Decreased effect of fentanyl, morphine, codeine, methadone and alfentanil when given with RIFAMPICIN

Possible CNS excitation or depression (hypertension or hypotension) when opiates are given with MAOIs

Question 4

What are the dose of opioids for breakthrough pain

Answer 4

1/10th to 1/6th of total daily dose