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44 Cards in this Set
- Front
- Back
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what are 3 drugs that decrease thermoregulatory threshold
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meperidine
tramadol dexmedetomidine |
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two drugs that are good for mediating pruritus caused by opioids
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ondansetrone
naloxone |
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What kind of opioid administration route yields the most pruritus
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intrathecal
neuroaxial |
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What kind of effect is pruritus after opioid administration
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Mu receptor mediated SE
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Opioids depress the respiratory centers of the brainstem, pontine, and medullary by acting on these receptors
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Mu 2
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How do opioids affect respirations
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increase TV
decrease RR decrease response to CO2 + hypoxia |
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What effect do opioids have during intubation
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blunt laryngeal reflexes
blunt increased IOP |
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Is morphine or fentanyl a better induction agent? Why?
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Fentanyl because it has anti-histamine, muscarinic, and dopaminergic properties
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What affect do opioids have on the CV
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Blunt SNS, Enhance PSNS
Decrease HR Decrease BP Decreases myocardial O2 demand Depresses baroreceptors |
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Opioids can react with what to cause asystole? Treat how?
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BB, Ca channel blockers
Robinol |
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What are demerol's effects on the heart
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increase MO2 demand
decrease CO tachycardia |
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What are morphine's effects on the heart
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decreases HR
hypotension histamine release |
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What kind of surgery is most resistant to opioids reduction of stress hormones
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Coronary bypass
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Receptor that causes anti-diuresis and decreased electrolyte excretion
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Mu agonist
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Receptor that causes diuresis and no change in electrolytes
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Kappa agonist
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What route and drug is most likely to cause urninary retention
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Morphine
intrathecal |
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Opioid DOC for renal failure
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Fentanyl family
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How do you treat a sphincter of Odi spasm
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Glucagon 2 mg
Atropine 0.2 mg NTG 50 mcg Naloxone |
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Receptors responsible for P/O N/V
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Mu
Delta |
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Where is the chemoreceptor zone loacated
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postrema -> medulla
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Responsible for delayed onset resp. depression
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opioid sequestration in the lungs
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Onset morphine
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10 min
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Duration morphine
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2 hours
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How long does intrathecal morphine have the potential to cause resp. depression
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24 hours
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Conditions that will increase morphine's half life
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renal failure
liver failure elderly |
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Opioid that causes mydriasis
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demerol
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Onset meperidine
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5-15 minutes
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How does meperidine cause problems in persons taking MAOIs
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serotonergic overactivity
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When is fentanyl given during induction sequence
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first. has a five minute peak
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Fentanyl peak
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5 minutes
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Opioid with the least pharmacokinetic changes
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Sufentanil
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Sufentanil peak
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4 minutes
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Alfentanil onset
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1 minute
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Remifentanil peak
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1 minute
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Recovery from remifentanil
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6-8 minutes
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Opioid that is metabolized by the plasma
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remifentanil
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Opioid that can't be given intrathecally
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remifentanil
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Opioid that will not last long enough to provide post op analgesia
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remifentanil
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Why is meperidine a myocardial depressant
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because of its local anesthetic affects
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What does morphine do to the mucociliary action in the trachea
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depresses
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Most non-ionized opioid at physiologic pH
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Alfentanil
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Which opioids have low volumes of distribution
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alf, su, remi
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Which opioids are good infusion medications
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alf, su, remi
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What is the interpatient variability of opioids
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5 fold
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