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23 Cards in this Set
- Front
- Back
Opioid agonists
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proto: morphine
other: fentanyl (Sublimaze, Duragesic) meperidine (Demerol) methadone (Dolophine) codeine oxycodone (Oxycontin) |
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opioid MOA
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act on the mu receptors ( analgesia, respiratory depression, euphoria, sedation), and to a lesser degree on kappa receptors (analgesia, sedation, decreased GI motility)
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opioid uses
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moderate to severe pain
sedation bowel motility codeine- cough suppression |
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opioid adverse
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respiratory depression- have naloxone (Narcan) ready
constipation orthostatic hypotension urinary retention- void every 4 hours cough suppression sedation biliary colic- avoid giving morphine to clients who have a history of biliary colic give meperidine as an alternative opioid overdose (coma, respiratory depresson, pinpoint of pupils) -administer naloxone (Narcan) |
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opioid contraindications
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morphine- biliary tract surgery
meperidine- kidney failure because of accumulation of normeperidine, which can result in seizures and neurotoxicity Caution: asthma, emphysema, head injuries, infants, older adult pregnancy obese inflammatory bowel disease, enlarged prostate hepatic or renal disease |
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opioid interactions
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CNS depressants
anticholinergic agents, antihistamines, TCA- additive anticholinergic effects meperdine- MAOI- hypyrexic coma antihypertensives |
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opioid admin
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administer IV slowly over a period of 4-5 min- have naloxone (Narcan) and resuscitation equipment available
do not increase dosage without consulting provider do not abruptly stop taking meds |
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opioid effectiveness
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relief of moderate t osevere pain (postoperative pain, cancer pain, myocardial pain)
cough suppression resolution of diarrhea |
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agonist-antagonist opioids
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proto: butorphol (Stadol)
other nalbuphane (Nubain) buprenorphine (Buprenex) pentazocine (Talwin) |
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agonist-antagonist opioids MOA
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act on mu and kappa receptors
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agonist-antagonist opioids use
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relief of moderate to severe pain
treatment of opioid dependence (buprenorphine) adjunct to balanced anesthesia relief of labor pain |
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agonist-antagonist opioids adverse
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abstinence syndrome (cramping, hypertension, vomiting, fever, anxiety)- stop taking opioid agonists such as morphine before using agonist, antagonist meds such as pentazocine
have naloxone available |
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agonist-antagonist opioids contraindications
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MI, kidney or liver disease, respiratory depression, head injury, opioid dependence
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agonist-antagonist opioid interactions
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CNS depressants and alcohol may increase additive effects
opioid agonists may antagonize and reduce analgesic effects of the opioid |
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agonist-antagonist admin
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assess for opioid dependence prior to admininstration
do not increase dosage without consulting provider |
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agonist-antagonist opioid effectiveness
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relief of pain
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opioid antagonist
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proto: naloxone (Narcan)
other: naltrexone (Re VIa, vivitrol) methylnaltrexone (Relistor) |
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opioid anagonist MOA
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interfere with action of opioids by competing for opioid receptors
opioid antagonists have no effect in the absence of opioids |
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opioid antagonist use
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treatment of:
opioid overdose reversal of effects of opioids- such as respiratory depression reversal of opioid caused constipation in clients with late-stage cancer or other disorders |
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opioid antagonist adverse
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tachycardia and tachypnea
abstinence syndrome |
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opioid antagonist contraindications
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opioid dependency
acute hepatitis or liver failure |
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opioid antagonist admin
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naloxone has rapid first-pass inactivation and should be administered IV, IM or subQ
observe clients for withdrawal syndrome rapid infusion may cause hypertension, tachycardia, nausea, vomiting half-life of opioid analgesic may exceed half life of naloxone monitor respirations for 2 hours after admin |
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opioid antagonist effectiveness
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reversal of respiratory depression
reduced euphoria in alcohol dependency and decreased craving severe opioid caused constipation relieved |