Opioids Miscellaneous

Question 1

Opioids are indicated for analgesia when the pain is ________, _________, and ________.

Answer 1

severe, constant, and ACUTE

Question 2

What opioid can be used to relieve SOB in acute pulmonary edema

Answer 2

IV morphine

Question 3

True or False: you should prescribe opioids to relieve a cough

Answer 3

False

Question 4

For diarrhea, what medications can be used?

Answer 4

Diphenoxylate/atropine and loperamide

Question 5

What opioid is category B for pregnancy?

Answer 5

Oxycodone

Question 6

What opioids are category C for pregnancy?

Answer 6

Codeine, hydrocodone, and morphine should be avoided (esp during lactation)

Question 7

What general measures should be taken regarding opioid regimen?

Answer 7

Continue NSAIDs or APAP if they help

Pt Ed –> reduce pain, not eliminate

Question 8

A patient presents with mild to moderate pain, what should you start with?

Answer 8

Tramadol or hydrocodone

Question 9

A patient presents with severe pain, what should you start with?

Answer 9

Morphine, oxycodone, or hydromorphone

Question 10

When switching opioids, what should you use to find a comparable dose? How much of this comparable dose should you start with?

Answer 10

Equi-equivalent chart
Half
Cross-titrate the schedule

Question 11

ADRs of opioids - CNS effects

Answer 11

Euphoria
Sedation
Respiratory Depression
Miosis (no tolerance develops, vital for OD**)
N/V
Hyperalgesia
Withdrawal (taper = crucial)

Question 12

ADRs of opioids - Peripheral Effects

Answer 12

Constipation
Biliary spasm
Urinary retention
True "allergy" is rare
Androgen deficiency

Question 13

What two opioids are true allergies most common?

Answer 13

Codeine

Morphine

Question 14

An 18 yo male with no pertinent PMH or hx of trauma presents to the clinic with decreased libido. He denies taking any meds or having this issue prior to 6 months ago. What might further digging reveal?

Answer 14

Chronic opioid use