Opioids EXAM Q - HRD

Question 1

Strong opioid - Buprenorphine (EXAM Q)

Answer 1

Can be agonist and antagonist.
- Can cause withdrawal symptoms
- Longer duration of action than morphine. Effective sublingually - 6-8hrs
HOWEVER effects are only partially reversed by naloxone

Patches
Pt advice:
Apply to dry non hairy/Irritated skin on upper torsos or outer arm.
- Heat or fever can increase absorption so AVOID heat.
- Remove after 72/96/7days
- AVOID same area after minimum 3 weeks. (7 days for prenotrix, hapoctasin, bupeaze, buplast, relevtec) (6 days transtec) (EXAM Q) TABLE ON PHONE

Remove if: breathing issues, drowsiness, confusion, dizziness

ConversionEXAM Q
Buprenorphine to fentanyl equivalent dose
- Can be any drug to convert to but ALWAYS Convert dose to equivalent morphine dose 1st then work out other
ANOTHER EXAM Q - breakthrough calcs, How long patches should be on for.
- Tip generally: 5mcg = 7 days, 35mcg = 4 days

Question 2

Strong opioid - Methadone

Answer 2

Less sedating - Morphine
Only best used OD
Miss 3 or + days = overdose risk BC lost tolerance.

OTHER Strong opioids
Oxycodone
- Like morphine, Main use pain control in palliative care

Pethidine
- Prompt but short lasting analgesia
- Less constipating than morphine

Tramadol
- Analgesia by opioid affect and enhancement of seratogenic and adrenergic pathways