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23 Cards in this Set

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  • Back
Opioid agonists
proto: morphine
other: fentanyl (Sublimaze, Duragesic)
meperidine (Demerol)
methadone (Dolophine)
oxycodone (Oxycontin)
opioid MOA
act on the mu receptors ( analgesia, respiratory depression, euphoria, sedation), and to a lesser degree on kappa receptors (analgesia, sedation, decreased GI motility)
opioid uses
moderate to severe pain
bowel motility
codeine- cough suppression
opioid adverse
respiratory depression- have naloxone (Narcan) ready
orthostatic hypotension
urinary retention- void every 4 hours
cough suppression
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)
opioid contraindications
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
inflammatory bowel disease, enlarged prostate
hepatic or renal disease
opioid interactions
CNS depressants
anticholinergic agents, antihistamines, TCA- additive anticholinergic effects
meperdine- MAOI- hypyrexic coma
opioid admin
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
opioid effectiveness
relief of moderate t osevere pain (postoperative pain, cancer pain, myocardial pain)
cough suppression
resolution of diarrhea
agonist-antagonist opioids
proto: butorphol (Stadol)
other nalbuphane (Nubain)
buprenorphine (Buprenex)
pentazocine (Talwin)
agonist-antagonist opioids MOA
act on mu and kappa receptors
agonist-antagonist opioids use
relief of moderate to severe pain
treatment of opioid dependence (buprenorphine)
adjunct to balanced anesthesia
relief of labor pain
agonist-antagonist opioids adverse
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
agonist-antagonist opioids contraindications
MI, kidney or liver disease, respiratory depression, head injury, opioid dependence
agonist-antagonist opioid interactions
CNS depressants and alcohol may increase additive effects
opioid agonists may antagonize and reduce analgesic effects of the opioid
agonist-antagonist admin
assess for opioid dependence prior to admininstration
do not increase dosage without consulting provider
agonist-antagonist opioid effectiveness
relief of pain
opioid antagonist
proto: naloxone (Narcan)
other: naltrexone (Re VIa, vivitrol)
methylnaltrexone (Relistor)
opioid anagonist MOA
interfere with action of opioids by competing for opioid receptors
opioid antagonists have no effect in the absence of opioids
opioid antagonist use
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
opioid antagonist adverse
tachycardia and tachypnea
abstinence syndrome
opioid antagonist contraindications
opioid dependency
acute hepatitis or liver failure
opioid antagonist admin
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
opioid antagonist effectiveness
reversal of respiratory depression
reduced euphoria in alcohol dependency and decreased craving
severe opioid caused constipation relieved