Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex Review > Opioid & non-opioid analgesics 2 > Flashcards

Opioid & non-opioid analgesics 2 Flashcards

1
Q

How do opioids affect RR and tidal volume?

A

decrease RR, increased tidal volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

With opioids, we may see an increase in __________ if ventilation is not maintained

A

PaCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What effects do opioids have on SSEPs?

A

minimal effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the reason behind miosis with opioids?

A

Edinger Westphal nucleus stimulation–> increased PNS stimulation of ciliary ganglion and oculomotor nerve CN3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

With morphine and meperidine, we may see a decrease in __________

A

BP as a result of histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is the baroreceptor reflex affected with opioids?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is myocardial contractility affected with opioids?

A

no; myocardial depression can occur if combined with N2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes the lowest increase in biliary pressure and contraction of sphincter of Oddi?

A

meperidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the effects that opioid has on gastric emptying and peristalsis?

A

prolonged
slows peristalsis–> constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do opioids affect thermoregulation?

A

resets hypothalamic temperature set point–> reduced core body temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the classifications of opioids?

A

naturally occurring
semisynthetic
synthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

____________ is the standard by which all other opioids are compared

A

Morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Opioids ordered from most to least potent are

A

Sufentanil> fentanyl=remifentanil>alfentanil>hydromorphone>morphine>meperidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

____________ occurs when a person taking a drug will go through withdrawal upon discontinuation of that drug

A

Dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_____________ occurs when a patient requires higher doses of a drug to achieve a given effect

A

Tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

____________ is a disease; If a person cannot stop using a drug despite negative consequences from using that drug.

A

Addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tolerance develops to nearly all the side effects associated with opioids with the exception of

A

miosis and constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Patients who are physically dependent on opioid agonists will experience

A

s/sx of withdrawal upon discontinuation of these drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are early s/sx of withdrawal?

A

diaphoresis
insomnia
restlessness

20
Q

What are later s/sx of withdrawal?

A

abdominal cramping
N/V

21
Q

What are the naturally occurring opioids?

A

phenanthrene derivatives= morphine, codeine

22
Q

What are the semisynthetic opioids?

A

morphine derivatives= hydromorphone, naloxone, naltrexone, heroin
thebane derivatives= oxycodone

23
Q

What are the synthetic opioids?

A

piperidines= meperidine
phenylpiperidines= fentanyl, sufentanil, remifentanil, alfentanil
diphenylpropylamines= methadone

24
Q

A dose of fentanyl that is equal to 10 mg of morphine is

A

100 mcg

25
Q

A dose of sufentanil that is equal to 10 mg of morphine is

A

10 mcg

26
Q

A dose of remifentanil that is equal to 10 mg of morphine is

A

100 mcg

27
Q

A dose of alfentanil that is equal to 10 mg of morphine is

A

1000 mcg

28
Q

A dose of hydromorphone that is equal to 10 mg of morphine is

A

1.4 mg

29
Q

A dose of meperidine that is equal to 10 mg of morphine is

A

100 mg

30
Q

__________ occurs when tolerance to one drug produces tolerance to another drug that has similar functions or effects.

A

Cross-tolerance

31
Q

The time course of opioid withdrawal is a function of

A

the drug’s half-life

32
Q

Which opioids produce an active metabolite? (select 2)
a. morphine
b. remifentanil
c. alfentanil
d. meperidine

A

a. morphine
d. meperidine

33
Q

Except for ___________, all the opioids undergo __________________

A

remifentanil; hepatic biotransformation

34
Q

What opioids produce active metabolites?

A

morphine
meperidine
hydromorphone- it depends on what you read

35
Q

What is the active metabolite of meperidine?

A

normeperidine (increases CNS irritability)

36
Q

What is the active metabolite of morphine?

A

morphine-3-glucuronide (hyperalgesia, agitation) and morphine-6-glucuronide (respiratory depression, drowsiness)

37
Q

An opioid that produces an active metabolite may require a dose adjustment in a patient with

A

an impaired clearance mechanism (kidney or liver failure)

38
Q

Remifentanil is hydrolyzed in

A

the plasma by erythrocyte and tissue esterases

39
Q

Remifentanil is dosed at

A

lean body weight

40
Q

Normeperidine is ___________ as potent as its parent compound

A

one half

41
Q

Normeperidine (CNS effects)

A

reduces the seizure threshold and increases CNS excitability

42
Q

Signs and symptoms of CNS excitability include

A

muscle twitches, tremors, and seizures

43
Q

Meperidine should be avoided in

A

patients on dialysis and the elderly

44
Q

M3G causes

A

hyperalgesia, agitation, myoclonus, and delirium

45
Q

M6G causes

A

respiratory depression
drowsiness
N/V
coma

46
Q

______________ patients are more likely to experience respiratory depression and toxicity after morphine

A

Renal failure patients

47
Q

______________________ to patients with normal renal function can also cause M6G accumulation and toxicity

A

Chronic morphine administration

Apex Review (224 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions