Opioid toxicity Flashcards
T or F: We tx natural, semi-synthetic, and synthetic toxicities differently.
F
Absorption of opioids is dependent on what?
- specific opioid
2. route of admin
In opioid toxicity, tmax following oral administration may _____.
increase
T or F: Opioid distribution and metabolism is quite variable across different opioids and different inds
T
t1/2 for most opioids?
2-10h
Methadone t1/2?
8-59h
T or F: It’s important to determine WHICH opioid a pt is overdosing on upon presentation.
F
It’s more important to know that it’s an opioid that’s causing toxicity, but it’s not as important to know which one
Main sx’s assoc w/ opioid toxicity?
- resp depression
- CNS depression
- miosis (pinpoint pupils)
What is the worst outcome of opioid-induced CNS depression?
Coma
What is the most likely cause of hypotn in opioid toxicity?
Histamine release
Which opioid is most likely to cause QT prolongation?
methadone
Which opioid is most likely to cause tachycardia and HTN?
tramadol
GI sx’s assoc w/ opioid toxicity?
N/V, constipation/reduced bowel sounds
What movement disorder can occur due to opioids?
Muscular rigidity of the trunk > hypoventilation (diaphragm activity is reduced)
Skin side effect(s) of opioid toxicity? What causes it/them?
itchiness > histamine causes it
Besides the antidote, what other decontamination method could be used for opioid intoxication and when would it be used?
Whole bowel irrigation > for body stuffers/packers
Opioid intox antidote?
Naloxone
Naloxone onset of action?
1-5 mins
Duration of action for naloxone?
30-90 mins (usually closer to 30)
Adverse effects of naloxone?
Withdrawal effects:
- irritability, anger
- V/D
- shivering, diaphoresis, muscle pain
How should dosing of naloxone be applied?
start low, and increase to get desired response (breathing on own) and avoid withdrawal
Possible max dose of naloxone (for adults)?
10 mg
Why may doses of > 10 mg of naloxone be needed for opioid tox?
High potency of opioids
Difference b/w naloxone scheduling wrt NAPRA and SCPP?
SCPP: It’s unscheduled when indicated for emergency use
NAPRA: It’s schedule II when indicated for emergency use
