Week 5 Comfort Drugs Flashcards
An unpleasant sensation and emotional experience
pain
Pain meds work in the _____ to alter the way that pain impulses arriving from peripheral nerves are processed
CNS!
What med a class acts at a specific opioid receptor site in the CNS to cause analgesia, sedation, or euphoria
opioid agonist
Prototype drug for opioid agonists
morphine
T or F there is a rising problem of abuse of opioids
TRUE!!
indication for opioid agonists (morphine)
- relief of severe pain, acute or chronic
- preop med
- combination therapy
contradictions of opioid agonist
- pts w/ resp dysfunct
- recent GI/GU surgery
- during pregnancy, labor, lactation> can cross placenta/ milk
Adverse reactions of opioid agonist
- resp depression, orthostatic hypotension, sedation, pupil constriction, head injuries
Drug-to-drug interaction of opioid agonist
Avoid use with monoamine oxidase inhibitors, which increase the risk of resp depression
opioid agonist nursing considerations
- always have naloxone on hand
- monitor bowel mov’t
- don’t just use medication therapies
- check on before and after
- LOC/ neuro checks
- pt education> addiction/ what to watch out for
A postsurgical client has been receiving morphine by patient-controlled analgesic for 2 days. What action by the nurse best addresses potential adverse effects?
A. Administering a stool softener as prescribed
B. Auscultating the client’s lung for adventitious sounds
C. Encouraging active range of motion exercises
D. Applying calf compressors as prescribed
A!
Narcotics create a significant risk for constipation
What drug action is to stimulate certain opioid receptors but block other such receptors
Opioid Agonist- Antagonist
What is the prototype drug for opioid agonist-antagonist
Pentazocine
Indications for opioid agonist-antagonist
- relief of pain during labor and delivery
- relief of moderate to severe pain
Contradictions to opioid agonist-antagonist
- cases of physical dependence on an opioid> can cause withdrawal syndromes
- COPD or other resp dysfunction
- Acute MI, CAD, HTN; exacerbated by cardiac stimulatory effects of these drugs
What drug class and prototype increases the risk of cardiac arrhythmias
opioid agonist- antagonist (pentazocine)
Common adverse effects of opioid agonist-antagonist
- resp depression
- n/v , constipation
- dizziness, light headedness
- sedation, impaired mental processes
- dependence
Drug-drug interactions of opioid agonist-antagonist
- avoid use in pts who have previously received an opioid> it puts them more at risk for increased adverse effects
Nursing considerations for opioid agonist-antagonist
- caution w/ MI/ cardiac patients
- monitor s/s of withdrawl
- less likely to lead to addiction
- can be given during labor
The nurse is caring for a client who has experienced little pain relief. The care team is considering the use of pentazocine. What aspect of the client’s current status would necessitate cautious use of pentazocine?
A. The client has diverticulosis
B. The client had a myocardial infarction 18 months ago
C. The client takes over-the-counter laxatives and stool softeners regularly
D. The client has smoked cigarettes for four decades
B!
Pentazocine must be administered cautiously to clients with known heart disease because the drug may cause cardiac stimulation including arrhythmias, hypertension, and increased myocardial oxygen consumption, which could lead to angina, myocardial infarction, or congestive heart failure.
What prototype drug is for opioid antagonist class
naloxone
What drug class action binds strongly to opioid receptors but does not activate them and it blocks opioid receptors and reverses the effects of opioids
opioid antagonist
T or F opioid antagonists are very well absorbed and widely distributed
TRUE!!
Contraindications of opioid antagonist
- use caution w/ opioid addiction; s/s of withdrawal will occur
- cardiac diseases could be exacerbated by the reversal of the depressive effects of opioids
Common adverse effects of opioid antagonist
- associated with the blocking effects of the opioid receptors
- sweating, n/v, tachycardia, hypertension, anxiety
Nursing considerations of opioid antagonist
- make sure pt and staff are safe
- know baseline neuro and continue to monitor]
- resp status
- be aware of s/s of withdrawal
- cardiac diseases could be exacerbated if given
What order for naloxone would be appropriate for the nurse to administer for reversal of opioid effects?
A. 1 mg IV repeat every 10 minutes
B. 5 mg IV repeat every 15 to 30 minutes
C. 0.1 mg IV repeat every 2 to 3 minutes
D. 0.4 mg IV repeat every 5 minutes
C!
0.1 to 0.2 mg is given IV and then repeated every 2 to 3 minutes for reversal of opioid effects.
Children’s considerations with opioids
- calculate dose carefully
- all wt based
- safety and effectiveness of many of these drugs have not been established in children
Adult considerations with opioids
- encourage pts to ask for pain meds before the pain is acute/ severe
- contradicted during pregnancy and breastfeeding> if given during labor assess newborn for opioid effects
- reassess risk of addiction
Older Adults considerations with opioids
- more likely to experience adverse effects
- may have different responses to opioids than they did earlier in life
- more likely to experience drug toxicicity
morphine drug class
opioid agonist
naloxone drug class
opioid antagonist
pentazocine drug class
opioid agonist-antagonist
