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23 Cards in this Set
- Front
- Back
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- Opiod
- Opiate - Narcotic -Analgesic |
- Opiod – any drug with actions similar to Morphine
- Opiate –those drugs present in opium: Morphine, Codeine, Heroin - Narcotic – -drug capable of causing analgesia, CNS depression & physical depression -Analgesic: pain relief without LOC |
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Opioid Receptors:
- mu - kappa - delta |
- mu – most important – analgesia, ↓resp, euphoria, sedation, physical dependency, ↓GI motility
- kappa – mild/minor – sedation, analgesia, ↓GI motility - delta/epsilon: Analgsia |
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Morphine Sulfate
Type: |
Strong pure opioid agonists
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Morphine Sulfate
Uses: |
USES
Moderate to severe pain control Sedation Pulmonary edema Relevance: standard others of its class measured |
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Morphine Sulfate
Pharmacokinetics *routes * Parenteral * Enteral |
*routes
-IV, IM, SubQ -oral -Epidural & Intrathecal: subarachnoid * Parenteral - fast onset -effects can last up to 4-5 hrs * Enteral -slow onset -higher doses needed – first pass effect -effects can be 4-5 hours or 24 hours |
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Morphine Sulfate
INTERACTIONS (5) |
*CNS depressants
-Benzodiazepines, Barbiturates, Alcohol -↑sedation & respiratory depression *Anticholinergic Drugs -Atropine, Antihistamines -↑constipation & urinary retention *Antihypertensives *MAOI -excited delirium *Opioid Antagonists -Naloxone |
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Morphine Sulfate
Dose |
Prep 10mg/ml – 1mlAmp
Dose (IV, IM, SubQ Load- 0.1mg/kg Main- 2.5-5mg PRN 2.5mg in 1 min Administration *IVP *Supine *Reversal agent & resp support on hand |
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Morphine Sulfate
Effects Caution (4) |
CAUTION:
• Resp disorders • Labor/pregnancy • head injury • hypotension |
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Morphine Sulfate
Adverse effects (10) |
• Clinical Triad: Resp ↓, CNS depression, Pupil constriction miosis
• Hypotension: Histamine release, Baraceptor blockade • Urinary retention • Constipation • Cough suppression amitussive • Biliary Colic: Smooth muscle spasm within biliary ducts • Emesis: Stimulation of chemoreceptor trigger zone • ↑ ICP: Resp depression • Euphoria/dysphoria • Neurotoxicity |
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Fentanyl Citrate
Trade name: Type: |
Sublimaze©
Strong opioid agonists |
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Fentanyl Citrate
USED FOR: |
For breakthrough/rapid pain control
Induction/maintenance of anesthesia RAPID onset & SHORT duration |
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Fentanyl Citrate
Dose: |
Dose (IV, IM )
PAIN: 1mcg/kg INDUCTION: 3mcg/kg (max single 250mcg) 50mcg/min |
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Fentanyl Citrate
Compared to Morphine |
100x more potent than morphine
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Meperidine
Trade name: Type: |
Demerol©
Strong opioid agonists |
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Meperidine
Interactions facts |
Less potent than morphine and Shorter half life
Many drug interactions: MAOI, SSRI, TCA’s May lead to neurotoxicity Is narcotic of “exclusion” Good for biliary related pain |
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Hydromorphone
Trade name Type |
Dilaudid©
Strong opioid agonists |
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Hydromorphone
Uses |
Moderate to severe pain control
Alternative to Morphine for pain control Often used as antitussive |
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Hydromorphone
Compared to morphine |
10x more potent than morphine
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Naloxone
Trade type |
Narcan©
Opioid antagonists |
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Naloxone
Used for |
Reversal of opioid overdose
Focus on reversal of Respiratory depression Careful with dosing as withdrawal can be caused Mixed OD? |
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Naloxone
Pharmacodynamics |
-competitive antagonist of opioid receptors
-will antagonize actions of opioids |
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Naloxone
Dose |
Prep 0.4mg/ml – 10 ml Vial
Dose:( IV, IM, SubQ) 0.4mg-2mg Max total 10mg Overall max 10mg 0.4mg/min |
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Naloxone
Pharmacokinetics |
-IV, IM, SubQ
-immediate IV onset with effects lasting an hour -IM/SubQ onset is 2-5 min with effects lasting hours -2 hr half life -cannot be administered orally- first pass effect |
