Analgesics

Question 1

Nociception

Answer 1

detection of noxious stimuli or stimuli that are capable of damaging tissue

Question 2

what is important to remember about pain?

Answer 2

it is a personal and individual experience

Question 3

Selectively blocks the sensation of pain without blocking other symptoms or loss of consciousness

Answer 3

analgesic

Question 4

blocks nerve conduction and all local sensations including pain

Answer 4

local anesthetic

Question 5

causes loss of sensations and consciousness

Answer 5

general anesthetic

Question 6

At which site of action do opioids have their greatest effect?

Answer 6

at the higher centres of the CNS

Question 7

on which of the pain processes do opioids exert their effect?

Answer 7

on perception and modulation (transmission)

Question 8

What receptors do opioids bind to?

Answer 8

opioid receptors

Question 9

Opiate

Answer 9

any drug derived from opium (morphine, codeine)

Question 10

all opioid analgesics are?

Answer 10

full agonists or partial agonists at mu and kappa receptors

Question 11

examples of full agonist opioids?

Answer 11

morphine, codeine and fentanyl

Question 12

Example of partial agonist opioid?

Answer 12

butprenorphine

Question 13

where are mu receptors located?

Answer 13

in the brain (cortex, medulla, thalamus, limbic system, amygdala) and spinal cord

Question 14

depression of the respiratory centre caused by opioids is due to which receptor?

Answer 14

mu

Question 15

what is the prototype for opioid analgesics?

Answer 15

morphine sulphate

Question 16

opioids are less effective in?

Answer 16

neuropathic pain

Question 17

which type of receptor does morphine sulphate act on?

Answer 17

primarily mu

Question 18

what is the half life of morphine sulphate?

Answer 18

2-4 hours

Question 19

what are the most common non-narcotic analgesic?

Answer 19

NSAIDs

Question 20

What are examples of adjuvants?

Answer 20

antidepressants, anti seizure drugs, glucocorticoids

Question 21

why is severe asthma or other respiratory deficiencies contraindicated in morphine use?

Answer 21

because morphine can suppress respirations

Question 22

what is the number one series adverse effect with morphine?

Answer 22

respiratory depression

Question 23

how long do nausea and vomiting last with morphine

Answer 23

usually only for 1-3 days

Question 24

does constipation associated with morphine use get a tolerance?

Answer 24

no

Question 25

what is a med interaction of morphine?

Answer 25

CNS depressants such as antipsychotics, sedatives and alcohol. They can cause cumulative effects

Question 26

what is an example of a moderate opioid analgesic?

Answer 26

codeine (3-methylmorphine)

Question 27

Codeine is never given to?

Answer 27

children because they have an unpredictable metabolism

Question 28

what is an example of an opioid antagonist?

Answer 28

naloxone

Question 29

what is naloxone used for?

Answer 29

complete or partial reversal of opioid induced respiratory depression (overdose)

Question 30

what is important to note about naloxone?

Answer 30

it has a shorter half life than morphine therefore the person could go back into respiratory depression. This means they may need more frequent dosing of naloxone

Question 31

which pharmacological effects show tolerance?

Answer 31

analgesia and euphoria

Question 32

state that develops in which an abstinence syndrome will occur if a drug is abruptly withdrawn

Answer 32

physical dependence

Question 33

is opioid withdrawal lethal?

Answer 33

no

Question 34

Oral forms of morphine should be?

Answer 34

taken with food to minimize GI upset

Question 35

what does the nurse do if the patient’s respiratory rate drops to less than 12 per minute?

Answer 35

withhold dose and contact physician

Question 36

respiratory depression may be manifested by?

Answer 36

• less than 12 breaths per min
• dyspnea
• diminished breath sounds
• shallow breathing

Question 37

how do you manage constipation associated with opioid use?

Answer 37

ensure adequate fibre and fluid intake