Opioid Analgesics

Question 1

codeine sulfate MOA

Answer 1

opioid agonist

binds to opioid receptors

Question 2

codeine sulfate indications

Answer 2

opioid analgesic- pain

antitussive

Question 3

codeine sulfate contraindications

Answer 3

peds, pregnant, laboring, breastfeeding moms

asthma, resp insufficiency, apnea, paralytic ileus

Question 4

codeine sulfate AE/SE

Answer 4

N/V

Opioid SE- hypotension, bradycardia, sedation dizzy, constipation, urinary retention, resp. distress

Question 5

codeine sulfate interactions

Answer 5

other CNS depressants=

alcohol, antihistamines, barbiturates, benzos

Question 6

codeine sulfate nursing considerations/education

Answer 6

high abuse potential
Tylenol #3- codeine and Tylenol- don't take more Tylenol  
no benzo's
monitor resp, CNS depression, vital signs etc. 
only agonist w/ ceiling effect
have naloxone ready 
fall risk 
monitor urinary retention

Question 7

fentanyl (Sublimaze) MOA

Answer 7

opioid agonist

Question 8

fentanyl (Sublimaze) indications

Answer 8

pain- very potent analgesic

sedation/general anasthesia

Question 9

fentanyl (Sublimaze) admin

Answer 9

transdermal patch- chronic pain
IV- RAPID onset
.1mg= 10g of morphine

Question 10

fentanyl (Sublimaze) contraindications

Answer 10

sub abuse
asthma, resp insufficiency, apnea, paralytic ileus
pregnancy

Question 11

fentanyl (Sublimaze) SE/AE

Answer 11

HIGH abuse potential
normal opioid SE- hypotension, bradycardia, sedation dizzy, constipation, urinary retention, resp. distress
sedation- which may be desired

Question 12

fentanyl (Sublimaze) nursing considerations/education

Answer 12

high abuse potential 
monitor vital signs
have naloxone ready 
no Benzo's 
fall risk 
monitor urinary retention 
have naloxone ready

Question 13

morphine sulfate (MSIR/Roxanol) MOA

Answer 13

opioid agonist

Question 14

morphine sulfate (MSIR/Roxanol) admin

Answer 14

oral, IM, IM, rectal

epidural

Question 15

morphine sulfate (MSIR/Roxanol) indications

Answer 15

severe pain

Question 16

morphine sulfate (MSIR/Roxanol) contraindications

Answer 16

renal impairment
after biliary surgery- induces spasm of the sphincter of oddi
asthma, resp insuff., apnea, paralytic ileus
pregnancy

Question 17

morphine sulfate (MSIR/Roxanol) SE/AE

Answer 17

resp depression, sedation, N/V, constipation, urinary retention, bradycardia, hypotension

Question 18

morphine sulfate (MSIR/Roxanol) interactions

Answer 18

alcohol
antihistamines
barbiturates
benzos 
other CNS depressants
MAOIs
st john wart

Question 19

morphine sulfate (MSIR/Roxanol) nursing considerations/education

Answer 19

high potential for abuse 
tolerance/cross sen w other opioids
monitor vitals
fall risk 
monitor urinary retention

Question 20

oxycodone (OxyIR/Percocet) MOA

Answer 20

opioid agonist- structurally related to morphine

Question 21

oxycodone (OxyIR/Percocet) indications

Answer 21

pain- analgesic

Question 22

oxycodone (OxyIR/Percocet) contraditions

Answer 22

if taking percocet= do not take more tylenol

asthma, resp insuff., apnea, paralytic ileus, pregnancy

Question 23

oxycodone (OxyIR/Percocet) SE/AE

Answer 23

N/V
hypotension
bradycardia
sedation
dizzy/drowsy
urinary retention/ constipation 
resp. depression

Question 24

oxycodone (OxyIR/Percocet) interactions

Answer 24

alcohol
antihistamines
barbiturates
benzos 
other CNS depressants

Question 25

oxycodone (OxyIR/Percocet) nursing considerations/education

Answer 25

``` percocet- no more Tylenol no benzos monitor vitals, urinary retention/bowel fx fall risk normal opioid considerations ```

Question 26

acetaminophen (tylenol) MOA

Answer 26

non-opioid analgesic | COX inhibitor limited to CNS

Question 27

acetaminophen (tylenol) indications

Answer 27

mild-mod pain | fever

Question 28

acetaminophen (tylenol) contraindications

Answer 28

liver disease-hepatotoxicity | alcoholism

Question 29

acetaminophen (tylenol) AE/SE

Answer 29

hepatotoxicity

Question 30

acetaminophen (tylenol) interactions

Answer 30

liver disease alcohol warfarin

Question 31

acetaminophen (tylenol) dosing

Answer 31

FDA= no more than 4000mg/day manufacter= no more than 3000mg/day liver disease= no more than 2000mg/day

Question 32

acetaminophen (tylenol) nursing considerations/education

Answer 32

antidote- acetylcysteine | keep track of dosing per 24 hours

Question 33

tramadol (Ultram) MOA

Answer 33

non-opioid misc. analgesic | binds to opioid receptors, blocks reuptake of norepinephrine and serotonin

Question 34

tramadol (Ultram) indications

Answer 34

mod.- severe pain

Question 35

tramadol (Ultram) contraindications

Answer 35

not for patients over 75 intoxication under 12 yrs old

Question 36

tramadol (Ultram) AE/SE

Answer 36

similar to opioids drowsy, dizzy reduces seizure threshold**

Question 37

tramadol (Ultram) interactions

Answer 37

MAOIs | SSRIs, tricyclic antianxieties

Question 38

tramadol (Ultram) nursing considerations/ education

Answer 38

measure baseline vitals not for patient over 75 yrs old monitor seizure threshold

Question 39

naloxone (Narcan) MOA

Answer 39

opioid antagonist | blocks opioid receptors

Question 40

naloxone (Narcan) indications

Answer 40

reverse opioid oversdose

Question 41

naloxone (Narcan) contraindications

Answer 41

not effective on non-opioid drugs,

Question 42

naloxone (Narcan) AE/SE

Answer 42

ventricular arrhythmias, HR/ resp rate incr. abstinence syndrome

Question 43

naloxone (Narcan) nursing education/ cosniderations

Answer 43

duration of action 1-2 hrs | if giving post-op be prepared w/ alternative analgesic