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NUR 325 PATHO > Opioids (Exam 2) > Flashcards

Opioids (Exam 2) Flashcards

1
Q

Opioids for Pain Releif

A

-Morphine
-Hydromorphone
-Fentanyl
-Meperidine
-Codeine
-Oxycodone
-Hydrocodone
-Narcan/nalaxone (antidote)

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2
Q

General considerations for all Opioids

A

-All of them are HIGH ALERT DRIGS

-Assess LOC, BP, Pulse, and Respirations before and periodically during administration

-If RR is <10 min assess level of sedation (Respiratory depression is our BIGGEST CONCERN)

-Physical stimulation may be sufficient to prevent significant hypoventilation

-Subsequent does may need to be decrease by 25-50%

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3
Q

3 chemical classes of opioids:

A

-Morephine-like

-Meperideine-like

-Methadone-like

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4
Q

morphine

A

-Drug prototype

-MOA: mu agonist —- mimics the action of ednogenous opioids at the mu receptors

(morphine bids to the mu receptors and creates a response)

-SCHEDULE 2

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5
Q

morphine: interactions

A

Alcohol and CNS depressents

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6
Q

Morphine: Indication

A

-Moderate to severe pain

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7
Q

Morphine: Adverse Reactons

A

SERIOUS:
-Respiratory Depression
-CNS depression

COMMON:
-Constipation
-Itching
-Dry mouth

-Do not give to patient who have not taken opioids medication before

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8
Q

morphine: nursing consideration

A

All opioids:

May impair the mental/physical abilities required for operating machinery or car

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9
Q

hydrmorphone

A

-Opioid similar to morphine

-synthetic formulation

-Schedule II

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10
Q

Hydromorphone: indication

A

-SEVERE PAIN

-7x more strong than morphine

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11
Q

hydromorphone: side effects

A

same as other opioids

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12
Q

Fentanyl: Indicaitons

A

Synthetic opioid for moderate-severe pain, surgical indication, and chronic pain

-PO (buccal) (IV) (IM) and Transdermal (chronic cancer)

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13
Q

Fentanyl potency

A

-EXTREMELY POTENT

-0.1 mg = 10 mg of morphine

DOSES IN MICROGRAMS

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14
Q

merpedridine

A

-Synthetic opioid and schedule 2

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15
Q

merperidine: indicaitons

A

-Moderate to severe pain

-Weaker than morphine and shorter duration

-Less respiratory depression

-PO is half as effective as IV

-LOTS OF DRUG/DRUG interactions

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16
Q

Merperidine uses

A

-ED for migraines

-Post-opp to stop shivering

17
Q

Merperidine: Concern

A

With repeated doses breaks down to TOXIC metabolite

Seizures (STAR)

18
Q

Codeine

A

Schedule II alone and Schedule III when combined with acetaminophen

19
Q

Codeine: Indications

A

Mild to moderate pain, reduce coughing (antitussive)

20
Q

Codine: Precautions

A

Do not give to children younger than 18 related to life threatening breathing problems

21
Q

Codeine: Side effects

A

Nausaea

22
Q

Oxycodone

A

-Schedule II

  • # 1 drug used at UK on med-surg floor

-Semi-synthetic derivative of codeine

23
Q

Oxycodone: Indications

A

-10x more potent than codeine

-Moderate to severe pain

-High potential of abuse

24
Q

Time release oxycodone

A

OxyContin

25
Q

Oxycodone and acetaminophen

A

Percocet

26
Q

Hydrocodone: Indications

A

-Mild moderate pain and cough

-Cough suppressant

-Analgesic effect to codeine—-6x more potent than codeine

27
Q

Methadone

A

-Full synthetic opioid analgesic

-Schedule II

-Opioid of choice for DETOX treatment in opioid addiction

-Long half-life than other opioids

28
Q

Naloxone

A

Narcan = Opioid Antagonist

29
Q

Naloxone: MOA

A

-Binds to opioid receptors but DOES NOT ACTIVATE (clogs them)

Onset: <2 min

Route: IV, IM, or intranasal

30
Q

Naloxone: Indications

A

-Antidote to reverse effects of morphine and morphine-like drugs

31
Q

Naloxone: Adverse Reactions

A

-Abrupt reversal of opioid effects with RECURRENT pain

-Increased blood pressure

32
Q

Nursing Consideration: Opioid Naive Patient

A

-Crucial to know your patient (Elderly and Younger are more likely to be opioid naive)

-Know baseline neurological status

-Always start with lowest does unless OVERT signs of SEVERE pain

33
Q

Nursing Consideration: Opioids

A

CONSTIPATION:

-give stool softeners, hydrate, nutrition

-Can progress to paralytic ileus—especially in the post-op patient

Nausea and Vomiting:

-may need to give anti-emetic medication to help adress the N/V

34
Q

Key Card Opioids
Rank from strongest to weakest

A
  1. Fentanyl: Severe pain. Small dosages. Given transdermal for cancer patients
  2. Hydromorphone: Severe pain. 7x more strong than morphine.
  3. Morphine: Moderate-Severe pain
  4. Oxycodone: Moderate-Severe Pain. Most common.
  5. Mereperidene: Moderate-Severe. Migrane and Stop shivering
  6. Codeine and Hyrdocodone: Mild-Moderate. Used for coughing
  7. Methadone: Mild-moderate. Used as a detoxification drug due to long half life

NUR 325 PATHO (30 decks)

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