Wk 9. Opiods & Analgesics Flashcards Preview

Pharmacology > Wk 9. Opiods & Analgesics > Flashcards

Flashcards in Wk 9. Opiods & Analgesics Deck (30):
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1. Define opioid.

Any drug that has actions similar to those of morphine.

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2. Define opiate.

Applies only to compounds present in opium.

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3. Explain the WHO three-step analgesic ladder.

Start with a nonopioid. If no pain relief, give an opioid for mild-moderate pain. If severe pain, give an opioid for moderate-severe pain. May use nonopioids and adjuvants with opioids to provide more pain relief.

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4. An equianalgesic dose of a pain medication is equivalent to how much morphine IM?

10 mg morphine IM

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5. Which receptors are stimulated by opioid analgesics?

Mu and kappa

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6. Stimulation of which receptors can result in severe respiratory depression and physical dependence?

Mu receptors

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7. Morphine works best for what type of pain?

Constant, dull pain

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8. Morphine binds to receptors which are located where?

Brain and spinal cord

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9. What is the toxic metabolite of meperidine (Demerol)? What effects may it have?

Normeperidine. Agitation, irritability, tremors, seizures.

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10. Meperidine (Demerol) may interact with a variety of antidepressants because it increases what neurotransmitter?

Serotonin

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11. Most mixed agonists/antagonists are agonists at what receptor? Antagonists at what receptor?

Agonist – Kappa
Antagonist – Mu

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12. Administering a mixed agonist/antagonist with an opioid may lead to what?

Pain or withdrawal

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13. Name a commonly-used opioid antagonist.

Naloxone (Narcan)

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14. To which side effects of opioids do patients NOT develop a tolerance? What interventions are warranted?

Constipation, miosis (pinpoint pupils). Stress safe environment and nightlights, as well as the use of laxatives and stool softeners.

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15. Cross tolerance exists between morphine and what other drugs?

Other opioids

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16. Define physical dependence.

Physical dependence is an abstinence syndrome which will occur if the drug is stopped abruptly.

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17. Define addiction.

A behavioral pattern characterized by using a psychoactive substance despite physical, psychological, or social harm.

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18. What is a common cause of death from opioids? Opioids should be withheld if the respiratory rate drops to ___ or below.

Respiratory depression. 12.

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19. What 6 interventions can be used to prevent constipation with opioid use?

Exercise, fiber, fluid, stool softener, stimulant laxative, methylnaltrexone

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20. Sedation commonly occurs with opioid administration. What can be expected with prolonged administration?

Decreasing sedation

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21. Nausea and vomiting may be avoided with opioid use by what two interventions?

Pretreatment with an antiemetic, lying still

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22. What three interventions should a nurse teach a patient about the risk of orthostatic hypotension from opioids?

Lie down or sit if dizzy or lightheaded, change positions slowly, use ambulatory assistance

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23. Itching from opioids is mediated by what chemical?

Histamine

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24. How do opioids affect vision?

Causes miosis which impairs vision.

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25. How can opioids increase intracranial pressure (ICP)?

Opioids can decrease respirations which increase the amount of CO2 in the bloodstream. Elevated CO2 causes vasodilation which increases ICP.

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26. How do opioids affect the mother and fetus/neonate?

Opioids may suppress uterine contractions and cause respiratory depression of the neonate. The fetus may develop a physical dependence with prolonged use by the mother.

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27. Why is the administration of opioids done with precaution in inflammatory bowel disease?

Opioids can cause toxic mega colon or a paralytic ileus.

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28. What are the three symptoms in the classic triad of opioid toxicity?

Coma, respiratory depression, miosis (pinpoint pupils)

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29. What fraction of the total daily dose of opioids is usually given as a supplemental dose for breakthrough pain?

1/6 of the total daily dose

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30. Which route is preferred for the administration of opioids? How will the dose compare to an intravenous dose?

Oral, oral doses are higher