Opioids

Question 1

Controlled substance schedule

Answer 1

Il

Question 2

Opioid agonist list

Answer 2

Fentanyl
Meperidine
Methadone
Codeine
Oxycodone
Hydromorphone

Question 3

Pharmacology action of opioid agonists

Answer 3

Act on mu receptors and a little on kappa receptors
Activation of mu = analgesia, respiratory depression, euphoria, sedation and dependence
Activation of kappa= analgesia, sedation, and decreased gi motility

Question 4

Therapeutic use of opioid agonists

Answer 4

Moderate to severe pain
Sedation
Reduce bowel motility
Cough suppression = codeine

Question 5

Urinary complications

Answer 5

Opioids can suppress awareness that bladder is full
Assess bladder for dissension every 4 to 6 hrs and monitor I+O
.anticholinergics can increase this complication

Question 6

Opioid toxicity triad

Answer 6

Coma
Respiratory depression = need mechanical ventilation and naloxone
Pinpoint pupils

Question 7

Precautions for opioid agonists

Answer 7

Asthma, emphysema, head injuries
Infants and elderly
Fat = slower metabolism
Ibs = risk of paralytic ileus
Enlarged prostate= risk of urinary retention
Renal or liver disease

Question 8

Contra indications for opioid agonists

Answer 8

Biliary tract surgery
Premature infants
Meperidine = kidney failure due to build up normeperidine which causes seizures
pregnancy risk category C= fetal dependence awing pregnancy and respiratory depression and decreased contractions during labor

Question 9

Opioid agonist interactions

Answer 9

CNS depressants= additive effect
Anticholinergic and tricyclic antidepressants
Antihypertensives have additive hypotensive effects

Question 10

Agonist antagonist opioid list

Answer 10

Buprenorphine
Nalbuphine
Pentazocine

Question 11

Pharmacology action of agonist antagonist opioids

Answer 11

Antagonists on mu = block respiratory depression
Agonists on kappa = analgesia but less strong
Lower abuse potential
Buprenorphine is the opposite to this

Question 12

Therapeutic uses of agonist antagonist opioids

Answer 12

Moderate to severe pain
Treatment of opioid dependence = buprenorphine
Labor pain

Question 13

Abstinence syndrome

Answer 13

Pcramping, hyper tension, vomiting, fever, anxiety
Happens when agonist antagonists are given to people dependent on agonist

Question 14

Contraindications and precautions for agonist antagonists

Answer 14

Use cautiously with mi, kidney and liver disease, respiratory depression, head injury and physical dependence on agonists

Question 15

Interactions with agonist antagonists

Answer 15

CNS depressants
Opioid agonists can antagonize and reduce analgesic effects of opioid