Rando exam 3 Flashcards
What is the prototype opioid?
Morphine
What are some other names for opioids?
Codeine, Fentanyl, Hydrocodone (with acetaminophen), Oxycodone
How do opioids relieve pain?
By inhibiting pain signal transmission from periphery to brain
How are opioids administered?
Well-absorbed with PO, IM, sub-Q, IV administration
Where are opioids metabolized?
In the liver, with metabolites excreted in urine
What can interfere with opioid excretion?
Liver or renal impairment
What are the CNS effects of opioids?
Analgesia, CNS depression, decreased mental and physical activity, respiratory depression, N/V, pupil constriction
What are the GI effects of opioids?
Nausea & Vomiting, slow motility, constipation, bowel and biliary spasm
What are the GU effects of opioids?
Urinary Retention, hesitancy, loss of libido
What is the Opioid Overdose Triad?
Coma, miosis, and respiratory depression
What is the Black Box Warning for opioids?
Present with all opioid analgesics due to potentially fatal adverse effects and risk of drug abuse
What are some opioids with Black Box Warnings?
Fentanyl, hydromorphone, methadone, oxycodone, and oxymorphone
What are contraindications for opioid use?
Existing respiratory depression, chronic lung disease, liver or kidney disease, depression of GI activity, diarrhea caused by toxic poisons
What should be considered when using opioids in patients with head trauma?
Caution due to exacerbated CNS effects
What is the primary use of opioids?
Prevent or relieve acute or chronic pain
What are some specific conditions for opioid use?
Acute MI, biliary or renal colic, burns, postoperative states, cancer
What is the effect of opioids on anxiety?
Decreases anxiety
What should be monitored in patients using opioids?
Patient response to the drug, adverse effects, timing of analgesic doses
What is the prototype opioid antagonist?
Naloxone (Narcan)
What is the action of opioid antagonists?
Reverses the effects of opioids
What are the adverse effects of opioid antagonists?
Tachycardia, tachypnea, risk for arrhythmias, abstinence syndrome
How should Narcan be administered?
IV, IM, SC, or spray; NOT oral
