T3-Analgesics: Opioids-MJ Flashcards Preview

Pharm I > T3-Analgesics: Opioids-MJ > Flashcards

Flashcards in T3-Analgesics: Opioids-MJ Deck (38):
1

The drugs mentioned in the PPT only activate __ & __ receptors.

Mu and Kappa

2

What are the receptor locations?

GI tract--constipation
CNS- pain relief, sedation, decreased respiration

3

If the dose is too high, what CNS issue may become problematic?

Decreased respiration--can lead to respiratory depression

4

What opioids are strong opioid agonists?

Fentanyl
Hydromorphone
Meperidine
Morphine

5

What opioids are moderate-to-strong opioid agonists?

Codeine
Hydrocodone
Oxycodone

6

What two from the strong opioid agonists should we NOT give to the opioid naive?

Fentanyl and hydromorphone

7

Which strong opioid agonist drug can not be given for more than 48 hours? Why?

Meperidine- toxic metabolites will build up; can cause seizures

8

Out of the strong opioid agonists drugs, which do we like to give?

Morphine

9

The moderate-to-stronge opioid agonists (codeine, hydrocodone, oxycodone) are usually joined with _____.

Tylenol products

10

What are the 4 safety issues with opioids?

Respiratory depression (fatal)
Acetaminophen and hepatotoxicity
Risk for addiction, abuse
Extended release not for opioid naive

11

What is important for us to do since we know that opioids may cause respiratory depression?

Check respiratory rate before giving drug and after

Hold drug (and contact prescriber) if respiratory rate is less than 12!

12

Why do clients need to know the risk of acetaminophen and hepatotoxicity?

They may also be taking tylenol products and that is not a good combo!!

13

Is risk for addiction and abuse with opioids common?

Not as common as we might think

14

Who can take an extended release opioid?

Clients who have taken these meds for a long time

NOT FOR THE OPIOID NAIVE

15

Head injuries and opioids:
Can increase _____
Complicates the ____

Increase ICP (inter cranial pressure)
Complicates the diagnosis

16

ICP causes a decreased respiratory rate which causes ___ CO2 levels--> increased ______ and increased ___ in the brain

Decreased respiratory rate--> Increased CO2--> increased vasodilation --> increased pressure in the brain

17

What are some other causes of ICP?

Nausea
Myosis (small pupil)
Mental clouding/confusion

18

Opioids may be common but we need to know they are _____!

Dangerous

19

Patient education for opioids: Bowel regimen
What is important to educate the patient on here?

The receptors these opioids work on are in GI tract and CNS. If the receptors in the GI tract get activated that can lead to constipation. Giving drugs to prevent constipation is important.

20

Patient education for opioids: Why should clients avoid ETOH, benzodiazepines, or other CNS depressants?

The CNS receptors are acted on by opioids. They already cause CNS depression. We don't need them to have double the CNS depression

21

Patient education for opioids: Patients need to have caution with driving or other things that require _____ because some people are highly sensitive with these drugs!

Concentration

22

Patient education for opioids:What are common S&S that patients need to be aware of?

Itching and N/V is COMMON

23

Patient education for opioids: Is N/V common throughout the whole treatment?

No, only at the start.

24

Patient education for opioids: If a patient is complaining about N/V. What can we tell them helps with it? What makes it worse?

Laying down=helps
Walking=worse

25

Patient education for opioids: If a patient complains of itching from the opioid and saying they think they have an allergic reaction, should we be concerned?

No! ITCHING IS A COMMON SYMPTOM. They need to know that too!

26

Patient education for opioids: Urinary retention is sometimes seen with patients taking opioids. What should we tell them regarding this?

Try to void q4h because you may not be aware of the sensation that you need to go

*We need to monitor the I&O

27

What is a PCA?

Patient controlled analgesia

28

What is a PCA used for?

So patients can control their pain

*used for severe pain

29

What is the basal rate?

Amount machine gives patient continually

1mg/h

30

What is the boost dose?

A docs order for an extra boost of med

Ex: 1/2 mg boost every 15 min

31

What is a lockout?

The total amount (basal rate and boost rate) that the patient may receive

EX: 6mg over 4 hours

32

When should we check the settings of the PCA?

the beginning of our shift!

33

What is some PCA education we should tell the patient?

Let them know it is not immediate relief--usually a 10 min lag
ONLY THEY can push the button-NOT family
Tell them about the lockout period so they aren't scared to use the PCA because fearful of an overdose

34

Fentanyl patch: How long does it take for the patch to work?

1 day

35

Fentanyl patch: Where should they put the patch?

Intact, clean, dry, hair free skin

36

Fentanyl patch: If the patient is too hairy, is it okay to let them shave and then put the patch on?

NO! Shaving causes skin to NOT be intact--if they put the patch on skin that isn't intact then absorption INCREASES

37

Fentanyl patch: How does a patient dispose of the patch?

Fold and flush!
This is a safety issue for children and pets. It would be too toxic for them

38

Fentanyl patch: What should patients avoid?

External heat sources