opioids Flashcards
what is the most effective pain reliever
opioids
what is an opioid
drug that has similar actions to morphine
what does naloxone (narcan) do
reverses respiratory and CNS depression caused by overdose
what is methylnaltrexone used for
treat opioid induced constipation, in late stage diseases (i.e. cancer)
what are the pharmacologic actions of morphine
pain relief, drowsiness, mental clouding, reduces anxiety, well-being, RESPIRATORY DEPRESSION, mitosis (shrinking of pupils)
what is morphine
strong opioid agonist
what is codeine
moderate to strong agonist, suppresses cough
what kind of push do you use for morphine
slow
what is a big adverse effect of morphine
respiratory depression
who are the most sensitive to respiratory depression
elderly and infants
what increases the risk of respiratory depression
using other drugs that have CNS depressants
examples of the other drugs that increase risk of respiratory depression with morphine
alcohol, barbiturates, benzodiazepines
how would you treat the adverse effect of constipation with morphine
physical activity, increases fiber + fluids, laxatives, stool softeners, polyethylene glycol
what does morphine do to blood pressure
orthostatic hypotension, use gait belt
what happens happens in the bladder with morphone
urinary retention and hesitancy, increases tone in sphincter and detrusor muscle
what is bad about the cough suppression with morphine
accumulation of secretions in airway
what are some cough remedies
codeine and hydrocodone based
what effect does the suprressed respirations correlated with morphine have on intracranial pressure
increases it b/c co2 is increased and dilates the cerebral vasculature
what is euphoria
exaggerated sense of well being
what is dysphoria
uncommon, anxiety + unease
what is something pts. should not do when taking morphine
hazardous activities, drive, etc.
what does a toxic dose of opioids do
pinpoint pupils, coma, respiratory depression
what do opioids cause to the eyes
miosis–> pupillary constriction
when is a morphine drip used
end of life care, eases their passing
what is physical dependence
abstinence syndrome with abrupt discontinuation, 10 hrs after last dose: yawning, rhinorrhea, sweating
if a pt is having the triad of symptoms for toxicity what do you do
NARCAN, give O2
what is fentanyl
other opioid, 100 times more potent than morphine`
what is important to know about transdermal patches for fentanyl
no heat: makes it release faster, rotate site
what is meperidine used for
short, painful things b/c it has short half life (i.e. resetting a shoulder)
what is hydromorphone (dilaudid)
10 times more potent that morphine, has same effects
what is codeine
10% converts to morphine in live, pain and cough suppression
how do you administer codeine
oral, sometimes with aspirin or acetaminophen
what is oxycodone
long-acting analgesic, abused by crushing + snorting or injecting
what is the most widely prescribed drug
hydrocodone
what is important about the pain assessment before administering drugs
essential component of pain management, subjective, MONITOR PT BEFORE AND 1 HOUR AFTER
what is the rule for dosing schedule for opioids
fixed schedule
what is important to consider with opioids
balance need for pain relief and minimize abuse desire
what fears need to be minimized with opioids
physical dependence and addiction
what is important about a PCA
pt + family education
when are opioid antagonists used
opioid overdose or constipation, reversal of neonatal respiratory depression, opioid addiction management
what does naloxone do
kicks/removes opioids off the receptors, competitive antagonist
what is titrated cautiously with naloxone
physical dependence
what is naltrexone used for
opioid and alcohol abuse
how does naltrexone work
prevents euphoria for opioid abuse, does NOT prevent cravings
what is tramadol
nonopiod, acts on CNS, typically used for back pain
what is important to know about tramadol
narcan does not work on this and there is a suicide risk
