lecture 77 pt 2 Flashcards
Rogers -- pain pt 2
what opioids are antagonists?
naloxone
what opioids are weak agonists?
codeine
tramadol
what opioids are full agonists?
morphine
hydrocodone
hydromorphone
oxycodone
meperidine
fentanyl
methadone
what is tolerance?
medication becomes less effective over time and it takes a higher dose of the drug to achieve the same effect
what is dependence?
when a patient stops using a drug, their body goes through withdrawal
what is addiction?
continued use of a drug despite negative consequences
what is the INSPECT report?
collects and tracks controlled substance prescriptions dispensed to Indiana residents
available to registered healthcare providers and law enforcement
what are signs of opioid overdose?
sedation/decreased level of consciousness (LOC)
pinpoint pupils
decreased respiratory rate
bradycardia
hypotension
pale, clammy skin
what are signs of opioid withdrawal?
insomnia/agitation
dilated pupils
increased respiratory rate
tachycardia
hypertension
sweating
what are the important counseling notes of naloxone?
opioid antagonist that is available in IV (hospital) and nasal spray (community setting)
can precipitate opioid withdrawal
prescribe together with opioids in pts at risk for OD
what is the dosing of naloxone?
IV – 0.4 to 2 mg IV q2-3 min
Nasal Spray – 4 mg intranasal spray q2-3 min (alternate nostrils)
what are the risk factors associated with OD?
hx of OD
hx of SUD
higher opioid dosages – over 50 morphine mg equivalents (MME) per day
concurrent benzo use
when does opioid withdrawal onset with short-acting opioids (like heroin)?
8 to 24 hours after last use
duration is 4-10 days
when does opioid withdrawal onset with long-acting opioids (like methadone)?
12-48 hours after last use
duration of 10-20 days
what can be used to treat opioid withdrawal?
clonidine
buprenorphine
methadone
how does clonidine help opioid withdrawal?
helps with symptoms of withdrawal such as HTN, sweating, vomiting, and anxiety
