opioid Flashcards
buprenorphine/naloxone
Suboxone
Side effects: drowsiness, itching, blurred vision, palpitation, tachycardia, HA, mental changes, hepatotoxicity, respiratory depression
Nursing considerations:
- Avoid hazardous activities until reaction known
- Avoid alcohol and CNS depressants
- IM: onset 15 min, peak 1 hour
- IV: onset 1 min, peak 5 minutes
- SL: onset and peak unknown
codeine
Side effects: drowsiness, n/v/anorexia, respiratory depression, constipation, orthostatic hypotension, dysuria, dyspnea, seizures, bradycardia
Nursing considerations:
- PO: onset 30-45 min, peak 1-2 hours, duration 4-6 hours
- IM/subQ: onset 10-30 min, peak 30-60 min, duration 4-6 hours
- Do not give if respirations are less than 12
- Avoid use with alcohol, CNS depressants
- Withdrawal symptoms may occur: n/v/, cramps, fever, faintness, anorexia
- Physical dependency may result from long term use
hydrocodone
Side effects: dizziness, constipation, n/v/, respiratory depression, imparied mental and physical performance, rahs, palpitations
Nursing considerations:
- Use with CNS depressants or alcohol may result in addictive CNS depression
- Use with caution in patient with pulmonary considerations
hydromorphone
Side effects: drowsiness, n/v/anorexia, respiratory depression, constipation, orthostatic hypotension, confusion, HA, rash
Nurisng considerations:
- PO: onset 15-30 min, peak 30-60 min, duration 4-6 hours
- IM: onset 15 min, peak 30-60 min, duration 4-5 hours
- IV: onset 10-15 min, peak 15-30 min, duration 2-3 hours
- subQ: onset 15 min, peak 30-90 min, duration 4 hours
- Rectal: duration 6-8 hours
- Do not give if RR<12
- Avoid use with alcohol, CNS depressants
- Withdrawal symptoms may occurs n/v/, cramps, fever, faintness, anorexia
- elderly patient may require lower doses
mepreidine
Demerol
Side effects: drowsiness, respiratory depression, orthostatic hypotension, confusion, HA, euphoria, bradycardia, diaphoresis, urticaria
Nursing consideration:
- PO: onset 10-15 minutes, peak 30-60 min, duration 2-4 hours
- IM: onset 10-15 min, peak 30-50 min, duration 2-4 hours
- IV: onset less than 5 min, peak 5-7 min, duration 2-4 hours
- subQ: onset 10-15 min, peak 30-50 min, duration 2-4 hours
- Do not give if RR < 12
- Avoid use with alcohol, CNS depressants
- o not co-infuse with barbiturates, aminophylline, heparin, morphine, methicillin, phenytoin, sodium bicarbonate, sulfadiazine, or sulfisoxazole
methadone
Dolophine, Methadose
Side effects: drowsiness, respiratory depression, orthostatic hypotension, confusion, HA, rash, arrhythmias, agiatation, n/v/anorexia, constipation/cramps
Nursing considerations:
- PO: onset 30-60 min, peak 30-60 min, duration 4-6 hours
- Do not give if RR< 12
- Avoid use with alcohol, CNS depressants
- Withdrawal symptoms may occurs: n/v/, cramps, fever, faintness, anorexia
morphine
Side effects: respiratory depression, sedation, euphoria, orthostatic hypotension, bradycardia, diaphoresis, urticaria
Nursing consideration:
- Continuous dosing ismore effective than prn; may be given by PCA
- PO: onset 15-60 minutes, peak 30-60 min, duration 3-6 hours
- IM: onset 10-15 min, peak 30-50 min, duration 2-4 hours
- IV: onset less than 5 min, peak 18 min, duration 3-6 hours
- subQ: onset 10-15 min, peak 30-50 min, duration 2-4 hours
- Withdrawal symptoms may occur: n/v, cramps, fever, faintness, anorexia
- Monitor for increased respiratory and CNS depression when given with cimetidine, clomipramine, nortriptyline, or amitriptyline
oxycodone
Side effects: dizziness, constipation, n/v/anorexia, constipation, confusion, HA, respiratory depression, imparied mental and physical performance, rash, palpitations, orthostatic hypotention, urinary retention
Nursing considerations:
- PO: peak 30-60 minutes, duration 4-6 hours
- Controlled-release: peak 3-4 min, duration 12 hours
- Do not give if RR < 12
- Withdrawal symptoms may occur: n/v, cramps, fever, faintness, anorexia
- Avoid alcohol and CNS depressants
