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NURS 575 - Pharm Workbook > Opioids and Narcotics > Flashcards

Opioids and Narcotics Flashcards

1
Q

(Generic/Brand)
MOA
Side effects

A

MOA:

Side effects:

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2
Q

(Generic/Brand)
Dose
Onset
Peak
Duration

A

Dose:

Onset:

Peak:

Duration:

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3
Q

(Generic/Brand)
Metabolism
Characteristics/observations

A

Metabolism:

Characteristics/observations:

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4
Q

Fentanyl/Sublimaze
MOA
Side effects

A

MOA:
1. Binds and activates g-coupled opioid receptors (mu specifically).
2. Activation causes GTP for GDP exchange which hyperpolarizes the cell and inhibits nerve activity.
3. Adenylate cyclase is downregulated which reduces cAMP.
4. Calcium ion influx into cell is reduced due to low cAMP.

Side effects:
Minimal myocardial/hemodynamic effects (open heart surgery induction)

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5
Q

Fentanyl/Sublimaze
Dose
Onset
Peak
Duration

A

Dose:
0.5 - 1 mcg/kg/dose for analgesia
25 - 50 mcg IV for intraoperative maintenance
50 - 150 mcg/kg for use as sole agent

Onset:
Patients state decrease in pain withinin 1 minute.

Peak:
4 - 6 minutes.

Duration:
30 - 60 minutes after single 100 mcg IV administration.

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6
Q

Fentanyl/Sublimaze
Metabolism
Excretion
Characteristics/observations

A

Metabolism:
CYP3A4

Excretion:
Urine by kidneys

Characteristics/observations:
High potency (100x of morphine)
Minimal/no histamine release, safe for asthmatics
Cheaper than sufent, alfent, and remi.
Minimal allergic reactions
Used for pain control in pts with renal failure d/t hepatic metabolism.

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7
Q

Sufentanil/Sufenta or Dsuvia
MOA
Side effects

A

MOA:
1. Opens K+ channels and inhibits Ca++ channels, causing increase in pain threshold and alteration in pain perception.
2. Inhibits ascending pain pathways.

Side effects:
Bradycardia, HTN, HoTN
Chest wall rigidity
Somnolence
Pruritis
Nausea, vomiting

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8
Q

Sufentanil/Sufenta or Dsuvia
Dose
Onset
Peak
Duration

A

Dose:
0.1 - 0.3 mcg/kg for induction
0.2 mcg/kg/hr for infusion

Onset:
1 - 2 minutes

Peak:
Not listed

Duration:
15 - 30 minutes

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9
Q

Sufentanil/Sufenta or Dsuvia
Metabolism
Excretion
Characteristics/observations

A

Metabolism:
CYP3A4

Excretion:
Urine by kidneys

Characteristics/observations:
1. 5 - 10x more potent than fentanyl.
2. Shorter duration than fentanyl.
3. Rapid onset with limited accumulation.

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10
Q

Alfentanil/Alfenta
MOA
Side effects

A

MOA:
1. Interacts with opioid mu-receptor in the brain, spinal cord, and other tissues.
2. Exerts effects on central nervous system.

Side effects:
Cardiac depression
Chest wall rigidity
Pupillary constriction

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11
Q

Alfentanil/Alfenta
Dose
Onset
Peak
Duration

A

Dose:
15 mcg/kg for induction
30 mcg/kg for intubation

Onset:
1 - 2 minutes

Peak:
3 - 5 minutes

Duration:
30 - 60 minutes

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12
Q

Alfentanil/Alfenta
Metabolism
Excretion
Characteristics/observations

A

Metabolism:
1. CYP3A4
2. Oxidative N-dealkylation and O-demethylation in the liver

Excretion:
Urine by kidneys

Characteristics/observations:
None listed

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13
Q

Remifentanil/Ultiva
MOA
Side effects

A

MOA:
Mu-opioid agonist.

Side effects:
Respiratory depression
Seizures, decreased CBF at high doses
Nausea, vomiting

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14
Q

Remifentanil/Ultiva
Dose
Onset
Peak
Duration

A

Dose:
1 - 3 mcg/kg over 1 minute for induction (single bolus).
0.5 - 1 mcg/kg/min for induction (drip).

Onset:
1.1 minutes

Peak:
1.5 - 2 minutes

Duration:
3 - 10 minutes

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15
Q

Remifentanil/Ultiva
Metabolism
Characteristics/observations

A

Metabolism:
Hydrolysis by nonspecific blood and tissue esterases, unaffected by renal or hepatic impairment.

Characteristics/observations:
1. Intubate within 8 minutes.
2. Rapid onset, peak effect, and duration.
3. Similar potency to fentanyl, 19x more potent than Alfentanil
4. Always used as a continuous drip.
5. Decreases SNS tone.
6. Less soluble than the other opioids.

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16
Q

(Morphine/Duramorph or Astromorph)
MOA
Side effects

A

MOA:
1. Activates descending inhibitory pathways of the CNS.
2. Inhibits transmission via the nociceptive afferent neurons of the PNS.

Side effects:
Bradycardia
Respiratory depression
Decreased CBF
Urinary retention
Constipation and ileuses
Histamine release
Nausea, vomiting, dryness

17
Q

(Morphine/Duramorph or Astromorph
Dose
Onset
Peak
Duration

A

Dose:
0.1 - 0.2 mg/kg every four hours or 2 - 4 mg for a 70 kg adult

Onset:
2 - 5 minutes

Peak:
15 - 30 minutes

Duration:
4 hours

18
Q

(Morphine/Duramorph or Astromorph)
Metabolism
Elimination
Characteristics/observations

A

Metabolism:
Liver via conjugation.

Elimination:
Urine by the kidney.

Characteristics/observations:
None listed.

19
Q

(Generic/Brand)
MOA
Side effects

A

MOA:

Side effects:

20
Q

(Generic/Brand)
Dose
Onset
Peak
Duration

A

Dose:

Onset:

Peak:

Duration:

21
Q

(Generic/Brand)
Metabolism
Characteristics/observations

A

Metabolism:

Characteristics/observations:

NURS 575 - Pharm Workbook (20 decks)

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