Opioids / Non-Opioids Flashcards
3 opioid receptors and which are used/most important
Mu, Kappa, Delta
Mu is most important, Kappa also used
Mu receptors produce which effects? (6 things)
respiratory depression physical dependence decreased GI motility analgesia sedation euphoria
Kappa receptors produce which effects? (4 things)
analgesia, sedation, psychotic effects, decreased GI motility
most opioid analgesics activate which receptors?
Mu
what do pure opioid agonists do to the receptors?
activate Mu + Kappa receptors
what do agonist-antagonist opioids do to the receptors?
activate Kappa + block Mu
what do pure opioid antagonists do to the receptors?
BLOCK all receptors
what’s an example of an opioid antagonist? and what is it used to treat?
naloxone
opioid overdose, reversal of post-op effects
example of pure opioid agonist
morphine
if a person has been on a pure opioid agonist, and is then given an agonist-antagonist, what are you concerned about?
the Mu receptor is now being blocked and this person will experience withdrawal symptoms
name some “strong opioid agonists”
“fentanyl + the m’s”
fentanyl, morphine, meperidine, methadone, hydromorphone
name some “moderate to strong opioid agonists”
“co”
codeine, hydrocodone, oxycodone
name some “agonist-antagonist opioids”
“bu”
butorphanol, pentazocine, buprenorphine, nalbuphine
major SE of opioids (7)
- which one is most serious?
- which one will not go away, even with tolerance?
- respiratory depression - most serious
- sedation
- nausea
- itching
- constipation - doesn’t resolve
- postural hypotension
- urinary retention
re: administration of opioids, if RR is <12, what would you do? and which nursing interventions could you try?
DON’T GIVE MED.
elevate HOB, O2 therapy, naloxone
what is prevention and treatment for constipation with opioid use?
prevention: fluid + fiber + activity
treatment: enema, stool softener (colace), stimulant laxative (senokot)
prevention and treatment for nausea/emesis with opioid use?
prevention: antiemetic
tx: lay flat + avoid movement
teaching/safety points for hypotension r/t opioid use
dangle, switch positions slowly, ask for assistance
FALL RISK
tx for urinary retention r/t opioid use
void q4, closely monitor I+O
strong opioids should be given with pain rating of what?
7-10
which drug would we use to tx opioid addiction w/low doses?
methadone
meperidine brand name
demerol
what is the special concern with using meperidine for chronic pain control?
it creates a toxic metabolite (normeperidine) that can cause seizures. this drug should only be used for 2 days max and patients should be assessed for nervousness, tremors + seizures
moderate to strong opioids should be given with pain rating of what?
4-7
