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Flashcards in Drugs affecting the central nervous system Deck (41)
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1

What are the definitions of acute, chronic, superficial, visceral

Acute=sudden; chronic=.3mo; visceral=organs, sm muscles

2

Opioid analgesics/opioid agonists common facts:

pregnancy B/controlled substance; opium was used in 350 BC; some drugs taken from opium include morphine/codeine

3

Where do opioids act on:

specific opoid receptors of CNS

4

Opioids activate what type of receptors from the CNS:

MU receptors and weak activation of Kappa (K) receptors

5

Activation of MU receptors do what:

analgesia respiratory depression, euphoria, sedation

6

Activation of K receptors cause:

analgesia and sedation

7

What isomers do opioids have:

Levo isomers=analgesic effect; dextro isomer=antitussive response

8

Which of the isomers cause dependence:

levos

9

What are the indications of opioids:

moderate/severe pain; pre-op/dyspnea and PE

10

What are some contraindications of opioids:

head injuries; asthma; hypotension; labor; renal/hepatic impairment

11

What is the dosage factors of analgesics in older adults:

adjust dose to low amount to decrease side effects

12

What is the dosage factors of analgesics in chronological age:

AGE, size, weight of pt

13

What is the dosage factors of analgesics in comorbidity:

D/t all types of other disease processes: dose should be adjusted

14

What is the dosage factors of analgesics in oncology pts:

Use the WHO pain scale; want comfort

15

What is the dosage factors of analgesics in substance abuse:

Still have to tx acute injury despite substance abuse; holding meds doesn't help them w/substance abuse

16

What are some side effects of opioids:

orthostatic hypotension, N/V/D, drowsiness, sedation, confusion, urinary retention

17

WHat are some adverse effects of opioids:

Respiratory depression, increased ICP, hypotension, pupillary constriction (sign of toxicity), dependence/tolerance, withdrawal

18

What are some drug interactions with: EtOH, hypnotic, antipsychotic drugs, muscle reaction

increases the effect

19

What are some common opioid analgesics:

morphine sulfate, fentanyl, Meperidine, codeine, and some (ONE side effects)

20

What is the pharmacodynamics of morphine sulfate:

binds with opioid receptors, paternal administration has rapid onset, duration is 3-5 hrs; controlled released tabs are 8-12 hrs

21

What are the pharmacokinetics of morphine sulfate:

metabolized in liver, iv for severe pain, sm amount crosses the blood brain barrier, short half life, crosses through placenta and breast milk

22

Common dosages of morphine sulfate in adult:

Adult: po=10-30mg, IV=4-10 mg;

23

Why are oral dosages of oral opioids:

oral dosages undergoes extensive metabolism on hepatic pass through the liver prior to reaching the systemic circulation

24

Incase respiratory distress would occur in a pt taking an opioid, what antagonists would we give to block effect of opioid:

Narcan

25

What are some S/S of opioid overdose:

respiratory depression, hypotension, drowsiness, pupillary constrictions=use Narcan (can be given in a post-op situation d/t excessive # of opioids)

26

Opioid withdrawal causes:

N/D, abd cramps, restlessness, irritability, watery eyes, runny nose, and diaphoresis, muscle twitching, increase BP/HR

27

What drugs would we Rx for withdrawal of opioids:

Methadone (half life is longer than opioids so methadone is given once a day)

28

What are some metadone Tx programs:

Weaning program (1st 2 days the dose is same amount as orig street drug, than after 2 days the drug is decreased to 5-10 mg) and maintenance program (dose remains consistance or given one dose every day)

29

What drug is given for opiate detoxification:

Clondine or Catapress to manage the withdrawal

30

What opioid agonist-antagonists combination is not given for cancer pain and is safe for using during labor:

Nubain