Pharmacology-Respiratory-Codeine

Front 1

A brand name of codeine is?

Back 1

Paveral

Front 2

Therapeutic classification of codeine is? (5)

Back 2

allergy
cold
cough remedies
antitussives
opioid analgesics

Front 3

Pharmacologic classification of codeine is?

Back 3

opioid agonists

Front 4

Indication of codeine is?

Back 4

Management of mild to
moderate pain
Antitussive in smaller doses

Unlabeled uses:
management of diarrhea

Front 5

MOA of codeine is?
Binds to ______ receptors in CNS?

CNS depression...decreases cough reflex and GI motility

Back 5

opiate...alters perception of and response to painful stimuli while producing
generalized ____ ______?

Front 6

Therapeutic effects of codeine are?

Back 6

decreased severity of pain
suppression of cough reflex
relief of diarrhea

Front 7

Use codeine with extreme caution in patients receiving _____ _______ (reduce initial dosage to 25% of usual dose)

Back 7

MAO inhibitors

Front 8

Assess what 3 things before and periodically during administration?

Back 8

blood pressure
pulse
respiration

Front 9

If respiratory rate is less than ____, assess level of sedation. Physical stimulation may be sufficient to prevent significant _______.
Dose may need to be decreased by how much? Initial drowsiness will diminish with continued use.

Back 9

10/min

hypotension

25-50%

Front 10

Assess bowel function routinely. Prevention of ______ should be instituted with increased (3) things

Back 10

constipation

intake of fluids
intake of bulk
laxatives

Front 11

Stimulant laxatives should be administered routinely if opioid use exceeds how much?

Back 11

2-3 days

Front 12

What should nurse assess about pain and at what peak time after administration?

Back 12

type
location
frequency

1 hour

Front 13

When titrating opioid doses, increases of _____ should be administered until there is either a ___ reduction in patient's pain rating on a numerical or visual analog scale or patient reports satisfactory pain relief.

Back 13

25-50%

50%

Front 14

What kind of chart should be used when changing routes or when changing from one opioid to another?

Back 14

equianalgesic chart

Front 15

Prolonged use may lead to? (3)

Back 15

physical dependence
psychhological dependence
tolerance

Front 16

Most patients who receive codeine for pain do not develop?

Back 16

psychological dependence

Front 17

If progressively higher doses are required, consider conversion to a?

Back 17

stronger opioid

Front 18

During antitussive use, nurse should assess?

Back 18

cough
lung sounds

Front 19

Lab test considerations...may cause?

Back 19

increased plasma amylase
increased lipase
concentrations

Front 20

If an opioid antagonist is required to reverse respiratory depression or coma, what is the antidote?

Back 20

naloxone (Narcan)

Front 21

Accidental overdosage of opioid analgesics has resulted in?

Back 21

fatalities

Front 22

Before administering codeine,

Back 22

have second practitioner independently check dose calculations, route of administration, and infusion pump programming

Front 23

Regularly administered doses may be more effective than ____ administration.

Back 23

prn

Front 24

Analgesic is more effective if given before pain becomes?

Back 24

severe

Front 25

Medications should be discontinued?

Back 25

gradually after long-term use to prevent withdrawal symptoms

Front 26

Combine codeine with nonopioid analgesics (such as aspirin or acetaminophen)

Back 26

#2 = 15 mg
#3 = 30 mg
#4 = 60 mg codeine

Front 27

Codeine as an individual drug is a Schedule?

Back 27

II substance

Front 28

Codeine in combination with other drugs, tablet form is Schedule?

Back 28

III

Front 29

In combination with other drugs, liquid form is Schedule?

Back 29

IV

Front 30

In combination with other drugs, elixir or cough suppressant is Schedule?

Back 30

V

Front 31

PO may be administered with?

Back 31

food or milk to minimize GI irritation

Front 32

With IM or subcutaneous, do not administer solution that is more than slightly?

Back 32

discolored or contains a precipitate

Front 33

Codeine is usually administered?

Back 33

IM or subcutaneous...slow IV has been used

Front 34

Patient should call for assistance when?

Back 34

smoking
ambulating

Front 35

Change positions slowly to avoid?

Back 35

hypotension

Front 36

Encourage patient to turn, cough, and breathe deeply every 2 hrs to prevent?

Back 36

atelectasis

Front 37

Advise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease?

Back 37

dry mouth

Front 38

Effectiveness of therapy can be demonstrated by?

Back 38

decrease in severity of pain
without a signficant
alteration in level of
consciousness or respiratory
status
suppression of cough
control of diarrhea