Opiod Analgesics Flashcards
What is the definition of pain?
An unpleasant sensory and emotional experience that is subjective and individual.
What is pain tolerance?
The amount of pain a patient can endure without interfering with normal function, affected by personality environment, culture, ethnic background, personal experience and individual circumstance.
How do opioid agonists work?
They bind to receptors in the brain and cause an analgesic response and decrease pain sensation.
How do partial opioid agonists work?
Bind to Kappa receptors and cause a weaker neuro response
How to opioid antagonists work?
Bind to pain receptors but does not reduce pain signals; counteracts Mu agonists (Narcan)
What are some issues and concerns with opioid use?
Tolerance, physical dependence, cumulative effects, and abuse.
What are some precautions and considerations with opioid use?
Decreases respiratory rate, pregnancy and lactation, avoid demerol and morphine with head injuries, watch for liver disease and impairment, watch with BPH and beta blockers.
What are some nursing interventions with opioids?
Assess vital signs, especially RR, BP, O2, assess LOC, frequent and continuous monitoring if on PCA or epidural, know s/e, listen for bowel sounds
What are some adverse reactions with opioids?
Respiratory depression, constipation, orthostatic hypotension, urinary retention, cough suppression, bilary colic, paralytic ileus, pruritis, vomit, increase icp, euphoria, sedation, miosis, neurotoxicity
What are some interactions with opioids?
Alcohol, antihistamines, barbituates, benzos, phenothiazine, MAO inhibitors -> all cause respiratory depression, seizures, hypotension.
How does morphine work and interventions with administering?
It binds to opiate receptors and produces CNS depression. PO dose passes through liver so assess function, monitor VS and LOC, count pills in hospital.
How does hydromorphone (dilaudid) work and some interventions?
It binds to opiate receptors; it is semi-synthetic and 8-10x more powerful than morphine with rapid onset. Assess for abuse and toxicity because of short half life
How does merperidine (Demerol) work and some interventions?
It binds to opiate receptors in CNS, avoid with lactating mothers, monitor for seizures and cardiac issues, beta blocker use can cause liver toxicity.
How does fentanyl work and what is it for?
It binds to opiate receptors in the CNS and it is for premedication for anesthesia or severe pain.
How does codeine work and what is it for?
It binds to various opioid receptors and is for mild/moderate pain and cough suppression.
