Analgesic Flashcards

Question

Opioid Drugs Meperidine

Answer 1

not recommended for long-term use because of the accumulation of a neurotoxic metabolite, normeperidine, which can cause seizures.

Answer 2

Drug reaches a maximum analgesic effect. Analgesia does not improve, even with higher doses. -Codeine phosphate -Pentazocine -Nalbuphine

Answer 3

Agonists Agonists–antagonists Antagonists (nonanalgesic)

Answer 4

Bind to an opioid pain receptor in the brain Cause an analgesic response (reduction of pain sensation)

Answer 5

Binds to a pain receptor and causes a weaker pain response than full agonists kappa (k) or mu opioid receptors Also called partial agonists or mixed agonists used in pts who are addicted to opioids and in obstretical pts (avoid oversedation of mom and fetus)

Answer 6

Reverse the effects of opioids on pain receptors Bind to pain receptors and exert no response Also known as competitive antagonists

Answer 7

Ability to provide equivalent pain relief by -calculating dosages of different drugs or -routes of administration that provide comparable analgesia Examples: morphine, hydromorphone, oxycodone, hydrocodone bitartrate, fentanyl Continuous release vs. immediate release formulations

Answer 8

Mainly used to alleviate moderate to severe pain Often first line agents analgesic in immediate post operative setting Often given with adjuvant analgesic drugs to assist primary drugs with pain relief Balanced anaesthesia

Answer 9

Cough centre suppression Treatment of diarrhea

Answer 10

Known drug allergy Severe asthma Respiratory insufficiency Elevated intracranial pressure Morbid obesity or sleep apnea Paralytic ileus Pregnancy

Answer 11

Central nervous system (CNS) depression -Leads to respiratory depression -Most serious adverse effect Nausea, vomiting, constipation, biliary tract spasm Urinary retention Hypotension, palpitations, flushing Itching, rash, wheal formation Pinpoint pupils indicating a possible overdose

Answer 12

A common physiological result of chronic opioid treatment State of adaptation Result: larger dose is required to maintain the same level of analgesia

Answer 13

Physiological adaptation of the body to the presence of an opioid Opioid tolerance and physical dependence are expected with long-term opioid treatment and should not be confused with psychological dependence (addiction).

Answer 14

Addiction: a pattern of compulsive drug use characterized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief

Answer 15

Naloxone hydrochloride Naltrexone (ReVia®) Regardless of withdrawal symptoms, when a patient experiences severe respiratory depression, an opioid antagonist should be given.

Answer 16

Naloxone has a stronger affinity to opioid receptors than opioids, such as heroin or oxycodone, so it knocks the opioids off the receptors for a short time (30 to 90 minutes). This allows the person to breathe again and reverse the overdose.

Answer 17

Occur in 2 weeks in opioid-naïve patients Gradual dosage reduction after chronic opioid use

Answer 18

Alcohol Antihistamines Barbiturates Benzodiazepines Promethazine Monoamine oxidase inhibitors Others

Answer 19

Natural opiate alkaloid (Schedule I) obtained from opium Less effective Ceiling effect More commonly used as an antitussive drug Gastrointestinal (GI) disturbance

Answer 20

Synthetic opioid (Schedule I) used to treat moderate to severe pain Parenteral injections, transdermal patches (Duragesic Mat®), sublingual effervescent tablet (Fentora®)

Answer 21

Hydromorphone (Dilaudid®): very potent opioid analgesic; Schedule I drug 1 mg of (IV) or (IM) hydromorphone is equivalent to 7 mg of morphine.

Answer 22

Synthetic opioid analgesic (Schedule I) Opioid of choice for detoxification treatment of opioid addicts in methadone maintenance programs Renewed interest in the use of methadone for chronic (e.g., neuropathic) and cancer-related pain Prolonged half-life of the drug: cause of unintentional overdoses and deaths Cardiac dysrhythmias

Answer 23

Naturally occurring alkaloid derived from the opium poppy Drug prototype for all opioid drugs; Schedule I controlled substance Indication: severe pain Oral, injectable, and rectal dosage forms; also extended-release forms

Answer 24

Structured similar to morphine Synthetic opioid Often combined with acetaminophen (Percocet tablets: typical is 325 mg acetaminophen and 5 mg of oxycodone)

Answer 25

Pure opioid antagonist Drug of choice for the complete or partial reversal of opioid-induced respiratory depression Indicated in cases of suspected acute opioid overdose Failure of the drug to significantly reverse the effects of the presumed opioid overdose indicates that the condition may not be related to opioid overdose.

Answer 26

Analgesic and antipyretic effects Little to no anti-inflammatory effects Available over the counter (OTC) and in combination products with opioids

Answer 27

Similar to that of salicylates Blocks pain impulses peripherally by inhibiting prostaglandin synthesis

Answer 28

Mild to moderate pain Fever Inability to take aspirin products

Answer 29

Maximum daily dose for healthy adults is 4 g/day, but Health Canada is considering lowering* ----2 000 mg for older adults and those with liver disease Inadvertent excessive doses may occur when different combination drug products are taken together. Be aware of the acetaminophen content of all medications taken by the patient (OTC and prescription). *Note: As of the date of writing of this text, Health Canada had not yet made this decision.

Answer 30

Drug allergy Liver dysfunction Possible liver failure G6PD deficiency Dangerous interactions may occur if taken with alcohol or other drugs that are hepatotoxic.

Answer 31

Even though available OTC, lethal when overdosed Overdose, whether intentional or resulting from chronic unintentional misuse, causes hepatic necrosis: hepatotoxicity. Long-term ingestion of large doses also causes nephropathy. Recommended antidote: acetylcysteine regimen

Answer 32

Central acting analgesic Treatment of moderate to moderately severe pain Potential adverse effects: seizures (with excess dosages) and serotonin syndrome (if taken with SSRIs) Frequently combined with acetaminophen (Tramacet)

Answer 33

Related to the marigold family Anti-inflammatory properties Used to treat migraine headaches, menstrual cramps, inflammation, and fever May cause GI distress, altered taste, muscle stiffness, joint pain May interact with aspirin and other NSAIDs, as well as anticoagulants

Answer 34

Before beginning therapy, perform a thorough history regarding allergies and use of other medications, including alcohol, health history, and medical history. Obtain baseline vital signs, intake and output. Assess for potential contraindications and drug interactions. Perform a thorough pain assessment, including pain intensity and character, onset, location, description, precipitating and relieving factors, type, remedies, and other pain treatments. ---Level of pain is now considered a “fifth vital sign.” ---Rate pain on a 0–10 or similar scale. Be sure to medicate patients before the pain becomes severe, so as to provide adequate analgesia and pain control. Pain management includes pharmacological and nonpharmacological approaches; be sure to include other interventions as indicated. Patients should not take other medications or OTC preparations without checking with their physicians. Instruct patients to notify physician about signs of allergic reaction or adverse effects.

Answer 35

Oral forms should be taken with food to minimize gastric upset. Ensure safety measures, such as keeping side rails up, to prevent injury. Withhold dose and contact physician if there is a decline in the patient’s condition or if vital signs are abnormal, especially if respiratory rate is less than 10 breaths/min. Check dosages carefully. ---Follow proper administration guidelines for IM injections, including site rotation. ---Follow proper guidelines for IV administration, including dilution, rate of administration, etc. Constipation is a common adverse effect and may be prevented with adequate fluid and fibre intake. Instruct patients to follow directions for administration carefully and to keep a record of their pain experience and response to treatments. Patients should be instructed to change positions slowly to prevent possible orthostatic hypotension. Monitor for adverse effects ---Contact physician immediately if the patient’s vital signs change, condition declines, or pain continues. ---Respiratory depression may be manifested by a respiratory rate of less than 10 breaths/min, dyspnea, diminished breath sounds, or shallow breathing.

Answer 36

Decreased perception of pain Decreased severity of pain Increased periods of comfort Improved activities of daily living, appetite, and sense of well-being Decreased fever (acetaminophen)

Answer 37

opioids- decrease LOC, respirations pain- is whatever the pt says it is visceral- organs somatic- bone, tendons, and muscle, skin (stimulation of sensory nerve fibres-pain) Pain threshold pain tolerance- the amount of pain a person can endure Neuropathic- nerve pain (diabetes) gallbladder pain- left side (pain in shoulder/ back/ scapula- referred pain) phantom pain- damage to BVs and nerves- amputation- still feel the pain Cancer pain- pressure from the tumours on organs/ tissues Central- stroke, MS, cancer Vascular pain- migraine PhysioMCST-phases nociceptive pain (video) Transduction-release of chemical picked up by Rs, nerve impulse to the brain Transmission- fibres activate R in brain Perception- subjective phenomenon, stimulus can be provoked differently Modulation- neural 1 activity, control pain transmission PCA-self medicate, hooked up to an IV for pain Breakthrough pain they can't wait for another drug to kick in, so we give them something short-acting Opioid- respiratory depression ANGINA- forms lactic acid because it does not get enough oxygen itch- common AE OF OPIOID

Answer 38

assist primary drugs (opioids) Amitriptyline (antidepressant) Gabapentin/ pregabalin (diabetic neuropathy)

Answer 39

codeine (affected by opioid ceiling effect) hydrocodone

Answer 40

not recommended

Answer 41

morphine, codeine, methadone, fentanyl

Answer 42

pentazocine weaker pain response partial agonists

Answer 43

Narcan reverse effects of opioids

Answer 44

respirations (ABCs)

Analgesic Flashcards

(68 cards)