Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FPM > Analgesics: Narcotics > Flashcards

Analgesics: Narcotics Flashcards

(42 cards)

Start Studying
1
Q

What is the MOA of narcotics?

A

Act as mu-opioid receptor agonists

-alter the perception and response to pain centrally and peripherally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which narcotics also inhibit reuptake of norepinephrine?

A

Modifies the ascending pain pathway
-also are mu- agonists

Tramadol

Tapentadol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which narcotic is a mu-agonist with weak kappa-antagonist activity?

A

Buprenorphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which narcotics are partial agonists of mu- and kappa-receptors?

A
  • butorphanol

- nalbuphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are contraindications of narcotics?

A

Severe respiratory disease / depression, including:
-acute asthma (unless patient is mechanically ventilated)

Paralytic ileus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are black box warnings of narcotics?

A

Serious life-threatening / fatal respiratory depression may occur
-monitor closely for respiratory depression
—especially during initiation / dose escalation

Opioids expose patients to risks of addiction, abuse, and misuse

  • potentially leading to overdose / death
  • assess each patient’s risk prior to prescribing
  • monitor all patients regularly for developing of these behaviors / conditions

Accidental ingestion can result in fatal overdose

  • even one dose of an opioid
  • especially in children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the black box warning for opioid use in pregnancy?

A

Prolonged use during pregnancy can result in neonatal withdrawal syndrome
-may be life threatening if not recognized and treated according to protocols developed by neonatology experts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are common members of the narcotics class?

A
  • buprenorphine
  • fentanyl
  • hydromorphone
  • methadone
  • hydro/oxycodone
  • tramadol
  • tapentadol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are uncommon members of the narcotics class?

A
  • alfentanil
  • butorphanol
  • codeine
  • levorphanol
  • meperidine
  • nalbuphine
  • opium tincture
  • oxymorphone
  • pentazocine
  • remifentanil
  • sufentanil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are brand names of buprenorphine?

A
  • Buprenex
  • Belbuca
  • Probuphine
  • Butrans
  • Subutex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the dosage forms of buprenorphine?

A
  • injection
  • TD patch
  • buccal film
  • SC implant
  • SL tablet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is buprenorphine used for?

A
  • management of pain severe enough to require ATC, long term opioid treatment and for which alternative treatment options are inadequate
  • opioid dependence
  • opioid withdrawal in heroin-dependent hospitalized patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What pregnancy category is buprenorphine?

A

C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is buprenorphine dosing for pediatric acute pain (moderate-severe) for children 2-12 years?

A

IM, slow IV: 2-6 mcg/kg every 4-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is buprenorphine dosing for adults, usual dose?

A

0.15-0.6mg every 4-8 hours PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is buprenorphine dosing for adults, acute pain?

A

0.3mg IM/IV every 6-8 hours PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is buprenorphine dosing for adults with chronic pain, TD patch, opioid-naive?

Study These Flashcards
A

Initial: 5mcg/hour applied once every 7 days

-max patch dose of 20mcg/hour/7days

18
Q

What is buprenorphine dosing for adults with chronic pain, TD patch, receiving daily dose of 30-80mg oral morphine equivalent

Study These Flashcards
A

10mcg/hour/7days

19
Q

What is buprenorphine dosing for adults with chronic pain, buccal film, opioid-naive?

Study These Flashcards
A

Initial: 75mcg once daily

20
Q

What is buprenorphine dosing for adults with chronic pain, buccal film, receiving daily dose of 30-89mg oral morphine equivalents?

Study These Flashcards
A

Initial: 150mcg every 12 hours

21
Q

What is buprenorphine dosing for adults with chronic pain, buccal film, receiving daily dose of 90-160mg oral morphine equivalents?

Study These Flashcards
A

Initial: 300mcg every 12 hours

22
Q

What is buprenorphine dosing for adults with opioid dependence, SL tablets?

Study These Flashcards
A

Day 1: 8mg PO

Usual range: 12-16mg/day during induction

Target dose: 16mg/day maintenance

23
Q

What is buprenorphine dosing for adults with opioid withdrawal in heroin dependent hospitalized patients (unlabeled use), IV?

Study These Flashcards
A

0.3-0.9mg every 6-12 hours

24
Q

How is buprenorphine dosing affected by hepatic impairment, buccal film / SL tablet?

Study These Flashcards
A

For severe impairment (Child-Pugh class C):

-reduce starting dose and titration dose by 50%

25
What are the most common adverse reactions of buprenorphine?
- sedation - hypotension - dizziness - nausea - vomiting - headache - respiratory depression - constipation - application site rash (patch, implant)
26
What are rare / severe / important adverse reactions of buprenorphine?
- respiratory depression - QTc prolongation - hepatotoxicity - severe allergic reactions
27
What are major drug interactions that affect buprenorphine?
CNS depressants and alcohol -increased sedation / dizziness CYP 3A4 inhibitors / inducers -alter its metabolism QTc prolonging drugs -may increaserisk of arrhythmias MAO-I inhibitors -may increased sedation
28
What are contraindications of the buprenorphine TD patch?
- management of mild / acute / intermittent pain - management of pain requiring short-term opioid analgesia - management of postoperative pain
29
What are essential monitoring parameters of buprenorphine?
-CNS depression -BP —for hypotension -liver enzymes
30
What are counseling points for buprenorphine?
-avoid excessive alcohol -may cause drowsiness —impair ability to operate machinery - may cause constipation requiring laxatives - may cause physical / psychological dependence with prolonged use - notify healthcare provider if pain unrelieved - do not place direct heat (heating pads) on patch - report any allergic reactions - never cut the TD patches -rotate patch sites on arms, chest, and back —apply to hairless / dry area -keep any used / unused patches away from children
31
What are black box warnings of buprenorphine?
Misuse / abuse by chewing / swallowing / snorting / injecting drug extracted from buccal film / TD system will result in: - uncontrolled delivery of buprenorphine - significant risk of overdose / death Concomitant use of BDZ / alcohol / other opioids / other CNS depressants may result in: - profound sedation - respiratory depression - coma - death Insertion / removal of implant are associated with risk of: - implant migration - protrusion - expulsion
32
What are rare but serious complications that may result from improper insertion of buprenorphine implant in upper arm?
-nerve damage -migration —resulting in embolism and death
33
What is preferred over buprenorphine monotherapy for maintenance of opioid dependence?
Combination of buprenorphine and naloxone -naloxone is a non-absorbed opiate antagonist that blocks effects of buprenorphine if snorted / injected —makes the combo an abuse-deterrent
34
What patch dose of buprenorphine is associated with an increased risk of QT interval prolongation?
20mcg/hour
35
What neurological disorder can buprenorphine exacerbate?
Cause seizures in patients at risk | -can lower seizure threshold
36
What do prescribers have to be certified in to prescribe buprenorphine tablets and TD patch?
REMS program
37
What are brand names of fentanyl?
- Abstral - Actiq - Duragesic - Fentora - Sublimaze - Lazanda - Subsys
38
What are the dosage forms of fentanyl?
- TD patch - TD device - buccal tablets - buccal lozenge - nasal spray - SL spray - SL tablet - injection
39
What is fentanyl injection used for?
- relief of perioperative pain | - adjunct to general / regional anesthesia
40
What is fentanyl TD patch used for?
-management of pain in opioid-tolerant patients —severe enough to require: —
41
What is fentanyl transmucosal lozenge, buccal tablet, NS, SL tablet / spray used for?
-management of breakthrough cancer pain in opioid-tolerant patients who are: —already receiving and tolerant to ATC opioid therapy for their underlying persistent cancer pain
42
What pregnancy category is fentanyl?
C

FPM (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions