OPIODS

Question 1

Side effects opoids

Answer 1

nausea, vomiting, constipation, pruritus, dizziness, dry mouth and sedation.

Question 2

Systemic opioids

Answer 2

Systemic opioids
Indication:
- intrapartum pain management
- not being used as much
Mechanism of action:
- readily crosses into placenta - impacts fetal heart rate
- women can still experience pain despite administration
Examples:
- morphine
- fentanyl
- remifentanil

Question 3

Opioid analgesics

Answer 3

Indication:
- Moderate to severe pain, usually acute pain, or cancer-associated pain
Mechanism of action:
- Opiods bind to opiod receptors, namely mu, delta, kappa receptors. Receptors are found in the brain, GIT, and spinal cord
- Most are mu receptors, therefore called ‘mu agonists’
- Tramadol and tapentadol produce analgesia via non-opioid pathways
Pure agonists:
- Morphine
- Oxycodone
- Codeine
- Tramadol
- Tapentadol
- Methadone
- Pethidine
Partial agonists:
- Buprenorphine
Adverse effects:
- Constipation
- Respiratory depression
- Sedation
- Nausea and vomiting
- Dispepsia
Specific opioids:
- Oxycodone-naloxone (Targin) - naloxone helps with opioid-induced GI effects such as constipation
Practice Points:
- used in combination with laxatives
- tapering off when coming off the drugs
- partial agonists have a ceiling effect
- monitor pain and sedation

Intrapartum pain management