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NRAD 201D Exam 5 > Pain - Opioids > Flashcards

Pain - Opioids Flashcards

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1
Q

What are the characteristics of acute pain?

A
  • abrupt onset, short duration
  • subsides once healing is complete or pain stimulus ceases
  • most likely associated with injury or surgery
  • is self-limiting
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2
Q

What are the characteristics of chronic pain?

A
  • persists longer than 6 months
  • interferes with ADLs
  • may lead to depression, physical/psychological dependence
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3
Q

What is considered to be mild pain on a scale of 0-10?

A

Mild = 1 - 3/10

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4
Q

what is considered to be moderate pain on a scale of 0-10?

A

Moderate = 4 - 6/10

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5
Q

What is considered to be severe pain on a scale of 0 - 10?

A

Severe = 7 - 10/10

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6
Q

What are the characteristics of Mu agonists?

A
  • opioids bind to opiate receptors in the CNS
  • Mu & Kappa = major receptor sites of pain
  • activation of these sites alter perception of pain and cause respiratory distress and constipation
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7
Q

Where are Mu & Kappa receptor sites located?

A

in the brain, down the spine, and around the GI system

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8
Q

What type of pain is morphine used for?

A

acute and chronic pain management

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9
Q

what different routes does morphine come in?

A

ALL FORMS - oral, parenteral (IM, SubQ, IV), and PR (rectal)

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10
Q

What is morphine derived from?

A

comes from the poppy plant

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11
Q

What are the characteristics of morphine?

A
  • no upper end
  • tolerance can develop = ↑ dose of drug to produce the same effect
  • there is a short acting & a long acting
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12
Q

What is the peak & duration of oral normal morphine?

A

Peak: 60 min
Duration: 4 - 5 hr

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13
Q

What type of pain is morphine (ER) used for?

A

chronic pain management

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14
Q

What form is morphine ER in?

A

oral

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15
Q

T/F morphine ER is used for breakthrough pain.

A

FALSE. short acting is used for break through pain (which is severe pain in the background of managed pain)

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16
Q

What are the characteristics of morphine ER?

A
  • used for opioid tolerant patients
  • doses scheduled daily, BID, or TID
  • must be swallowedd whole
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17
Q

what type of pain is hydromorphone used for?

A

• severe acute and chronic pain

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18
Q

what routes/forms does hydromorphone come in?

A

ALL FORMS - PO, PO-ER, parenteral (IV, IM, SubQ), PR (rectal)

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19
Q

what are the characteristics of hydromorphone?

A
  • less nausea than morphine - less adverse effects
  • ↑ risk for orthostatic hypotension & urinary retention
  • ↑ risk for respiratory depression - keep close eye on them
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20
Q

how much stronger is hydromorphone than morphine?

A
  1. 7 times greater potency than morphine = stronger

* *be careful of overdose

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21
Q

what type of pain is codeine used for?

A

mild to moderate pain

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22
Q

what are the characteristics of codeine?

A
  • antitussive action (suppresses cough)
  • “ceiling effect”
  • ↑ dose → ↑ risk of adverse effects
  • combined with acetaminophen or aspirin
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23
Q

What are the forms of codeine?

A

Oral - Tab or Syrup

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24
Q

What schedule is codeine in?

Study These Flashcards
A

schedule 5 drug

25
What type of pain is hydrocodone used for?
moderate to severe pain
26
what are the characteristics of normal hydrocodone?
* semi-synthetic opioid * stronger than codeine * combined with acetaminophen, varied doses (vicadine, norco) * used to be a schedule III → 2013 - Schedule II drug
27
Is there an extended release hydrocodone?
yes, extended release hydrocodone is called Zohydro ER. IT IS PURE HYDROCODONE
28
what is extended release hydrocodone used for?
severe chronic pain
29
what are the characteristics of extended release hydrocodone?
* only used when alternative treatment attempted. * opioid tolerant people only * no acetaminophen - PURE hydrocodone * not a PRN medication b/c of ER * swallow whole
30
what type of pain is fentanyl used for?
chronic persistent pain & management of breakthrough cancer pain
31
what are the different route/forms of fentanyl?
PO, buccal, sublingual, transmucosal, and transdermal
32
what are the characteristics of fentanyl?
* IV anesthetic for perioperative anesthesia | * used for opioid tolerant pts
33
how much stronger is fentanyl than morphine?
100 times more potent than morphine
34
what is special about transmucosal fentanyl?
mixed first pass/not first pass | • rapid absorption 25% into bloodstream, then medicated saliva is swallowed and goes through GI (first pass)`
35
what type of pain is transdermal fentanyl used for?
moderate to severe chronic pain
36
what are the characteristics of transdermal fentanyl?
* opioid tolerant patients * long-term chronic analgesic therapy * 6 - 12 hr to reach steady state * duration of action 72 hours - changed every 72 hrs
37
T/F this patch is transparent.
TRUE. make sure to document where it is placed. If lost, we have to look for it.
38
What type of pain is oxycodone used for?
moderate to severe pain
39
Is oxycodone short or long acting?
SHORT ACTING.
40
What is long acting oxycodone called?
oxyCONTIN - controlled release | • around the clock analgesia for extended period of time
41
What form/route is oxycodone and oxycontin available in?
PO
42
what is the onset, peak, and duration of oxycodone?
onset: 10-15 min peak: 60-90 min duration 3-6hr
43
what is the onset, peak, and duration of oxycontin?
onset: 10-15 min peak: 3 hrs duration: 12 hr
44
what specific type of pain is short acting good for?
breakthrough pain
45
what is the combo drugs of Percocet?
oxycodone & acetaminophen
46
what is the combo drugs of Percodan?
oxycodone & aspirin
47
what are the 6 adverse effect of opioid on the CNS?
• sedation, confusion, drowsiness, dizziness, floating feeling, and possible euphoria
48
what is the adverse effect of opioid on the respiratory system?
respiratory depression
49
what are the 2 adverse effects on the ♥ system?
hypotension, and bradycardia (peripheral vasodilation)
50
what are the 3 adverse effects on the GI system?
constipation (slows peristalsis), nausea & vomiting
51
what is the adverse effect of opioids on the GU system?
urinary retention
52
what are 2 miscellaneous adverse effects of opioids?
tolerance (when taking frequent doses) | physical/psychological dependence
53
T/F Adverse effects ↑ with ↑ doses.
TRUE
54
what type of pain is methadone used for?
moderate or severe chronic pain
55
what are the characteristics of methadone?
* opioid tolerant pts * schedule II drug * less severe euphoria s/sx * not first choice drug for mod/severe pain * methadone maintenance - detoxification & maintenance of opiate or heroin dependency * DOES NOT CURE DEPENDENCE
56
what should you do to monitor for oversedation?
``` • assess RR and level of sedation • consider holding opiates if RR < 12 breaths/min • respiratory depression if RR < 10/min - unresponsive to verbal cue - require painful stimuli (sternal rub) ```
57
what is the opioid antagonist called?
naloxone (Narcan)
58
what are the characteristics of narcan?
* reverses opioid inducer CNS & respiratory depression * reverses analgesia effects * home use available - subcutaneous & intranasal * onset: 1-2 min

NRAD 201D Exam 5 (4 decks)

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