Opioids

Question 1

drugs that relieve pain w/o causing LOC

Answer 1

analgesic

Question 2

any drug w actions like morphine

Answer 2

opioid

Question 3

compound present in opium -> take opiate and make an opioid

Answer 3

opiate

Question 4

dose that will produce the same degree of analgesia -> what dose of med 2 will have same pain tolerance effect as X mg of med 1?

Answer 4

equianalgesic

Question 5

withdrawal symptoms occur if the drug is stopped abruptly (expected over time)

Answer 5

dependence

Question 6

larger doses are required to achieve same response (expected over time)

Answer 6

tolerance

Question 7

What are the purposes of the comprehensive drug abuse prevention and control act of 1970?

Answer 7

1. Promotion of education/research
2. Strengthening enforcement
3. Making treatments & rehab facilities
4. Schedules for controlled substances

Question 8

high potential for drug abuse, no accepted medical use (heroin, LSD, marijuana)

Answer 8

Schedule I

Question 9

high potential for drug abuse with accepted medical use (morphine, oxycodone, codeine, amphetamines)

Answer 9

schedule II

Question 10

medically accepted drugs with less potential for abuse than schedules I and II, may cause dependence (codeine preparation - paired w other meds)

Answer 10

schedule III

Question 11

medically accepted drugs w less dependence risk than I-III
IV ex) ativan, valium
V ex) codeine in cough preparations

Answer 11

schedule IV & V

Question 12

T/F: Meds can jump between schedules depending on what meds are paired w it in manufacturing

Answer 12

TRUE ex) codeine

Question 13

what are some nursing safety implications related to opioids?

Answer 13

-account for all scheduled drugs
-countersign all discarded or wasted meds w 2 licensed nurses
-documentation and drugs on hand match
-drugs secure
-reporting mandatory by Peer Assistance Program

Question 14

What are the 7 dimensions of pain?

Answer 14

chronology
location
quality
quantity
setting
associated manifestations
aggravating and alleviating factors

Question 15

analgesia, respiratory depression, euphoria, reduced GI motility

Answer 15

mu receptor response

Question 16

analgesia

Answer 16

delta receptor response

Question 17

analgesia, dysphoria, psychotomimetic effects, respiratory depression

Answer 17

kappa receptor response

Question 18

What is the Glasgow Coma Scale?

Answer 18

-use if someone becomes groggy after opioid and before admin of morphine
GCS<8 -> intubate

Question 19

allows patient to admin their own pain reliever (ONLY PATIENT, no one else)

Answer 19

patient-controlled analgesia

Question 20

PCA teaching

Answer 20

-push button when pain is perceived
-better to push at onset
-DO NOT allow others to push
-do not push if not in pain

Question 21

overdose toxicity triad

Answer 21

-pinpoint pupils
-loss of consciousness
-respiratory depression

Question 22

morphine type

Answer 22

opioid agonist, analgesic

Question 23

morphine use

Answer 23

treats moderate to severe pain, preoperative sedation, reduces anxiety

Question 24

morphine pharm action

Answer 24

stimulation of mu & kappa receptors
mimics actions of naturally occurring opioids & endorphins

Question 25

morphine complications

Answer 25

-respiratory depression (hypoxia) -sedation (dizziness, lightheadedness) -hypotension -constipation -physical dependence & tolerance

Question 26

morphine admin

Answer 26

PO w food, IV, SL, transdermal, IM, subcutaneous

Question 27

morphine contraindications

Answer 27

hypotension, hypoxia, slow RR caution: head injury

Question 28

morphine interventions

Answer 28

check VS HOLD: SBP <100, RR <10, SpO2 <94%, and/or low GCS 7 dimensions of pain reevaluate

Question 29

morphine interactions

Answer 29

-other CNS depressants -anticholinergic meds -antihypertensive meds -opioid agonist-antagonists

Question 30

morphine client education

Answer 30

-constipation: ↑activity, fluids, fiber -lowest dose for shortest time -caution w other drugs

Question 31

naloxone type

Answer 31

opioid antagonist, antidote for opioid overdose

Question 32

naloxone use

Answer 32

treat opioid overdose, reverses opioid effects

Question 33

naloxone pharm action

Answer 33

strips ALL opioids off receptors, higher affinity for receptors so preferred binding/competes for opioid receptors

Question 34

naloxone admin

Answer 34

IM, IV, subq, intranasal

Question 35

naloxone complications

Answer 35

-PAIN -withdrawal from opioid -hypertension -tachycardia -N/V

Question 36

naloxone contraindications

Answer 36

previous reactions (rare) caution: head injury

Question 37

naloxone interactions

Answer 37

opioids

Question 38

naloxone interventions

Answer 38

-check VS before/during/after -half life concerns (duration of opioid is not same as naloxone duration) -pain

Question 39

naloxone client education

Answer 39

-discharge safety -home care -future prevention

Question 40

butorphanol type

Answer 40

opioid agonist-antagonist, analgesic

Question 41

butorphanol use

Answer 41

moderate pain, adjunct therapy - L&D, procedural sedation

Question 42

butorphanol pharm action

Answer 42

mu antagonist - less risk for respiratory depression & CNS effects, fewer analgesic effects kappa agonist

Question 43

butorphanol complications

Answer 43

↓RR & O2 saturation bradycardia hypotension orthostatic hypotension abstinence syndrome (mix of morphine and naloxone SE)

Question 44

butorphanol admin

Answer 44

IM, IV, intranasal

Question 45

butorphanol contraindications

Answer 45

acute myocardial infarction opioid dependency (can reverse opioid effects)

Question 46

butorphanol interventions

Answer 46

do not abruptly stop monitor pain & VS HOLD: SBP<100, RR<10, SpO2<94% and/or low GCS

Question 47

butorphanol interactions

Answer 47

other CNS depressants anticholinergics antihypertensives opioids ETOH

Question 48

butorphanol client education

Answer 48

short term use do not work or drive while taking ↑activity, fluids, fiber - prevents constipation do not abruptly stop