Shared Flashcard Set

Details

Pain & Osteoarthritis Opioids
Pain & Osteoarthritis Opioids
43
Pharmacology
Professional
09/21/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
What are opioids in combination (such as with APAP) used for?
Definition
For moderate pain
Term
Opioids used as single agents are used for?
Definition
severe pain
Term
Which opioids are classified as full opioid receptor agonists?
Definition

Codeine

Fentanyl

Hydrocodone

Hydromorphone

Methadone

Morphine

Oxymorphone

Term
The primary receptor for pain relief is what?
Definition
mu receptor
Term
full agonists are used for acute and chronic pain and have no ____ effect.
Definition

Ceiling (meaning that the dose can go up)

 

Term
Should opioids at high doses be rotated?
Definition
Yes!
Term
Long acting formulations of Morphine?
Definition
MS Contin
Term
Brand name of Morphine/Naltrexone
Definition
Embeda
Term
What's special about Kadian?
Definition

can be opened and the beads put down a NGT for control over 24 hours, or can sprinkle on applesauce

Term
What's special for Embeda?
Definition

If drug altered (for abuse) then naltrexone, an opioid blocker, is released. The capsules contents can be sprinkled on applesauce. Injection of crushed capsule contents can be fatal.

Term
Do opioids cross react?
Definition

Yes. Cross-reactivity with these agents (if allergy to 1 of the following, don't use another: morphine, codeine, hydrocodone, hydromorphone, oxycodone)

Term
If one has a morphine - group allergy, what should be chosen?
Definition
fentanyl, meperidine, methadone, tramadol
Term
Symptoms of an opioid allergy?
Definition

Difficulty breathing, severe drop in BP, serious rash, swellling of face, lips, tongue, larynx - use an agent in a different chemical class

Term
GI effects of opioids?
Definition
constipation, nausea, vomitting
Term
Opioids and constipation?
Definition

Tolerance usually develops to opioid side effects EXCEPT constipation

Term
How to treat constipation associated with opioids?
Definition

Constipation will likely require stimulant laxatives (e.g. senna bisacodyl) or osmotic laxatives (e.g. MOM). Sometimes, docusate (DSS) alone may be enough, or in DSS + stiumlant lax.

Term
What is Methylnaltrexone
Definition

Methylnaltrexone (Relistor) is a laxative for constipation due to opioids (it blocks gut opioid - receptors).

 

The patient must have failed DSS + laxative (senna, bisacodyl). Administer SC every other day

Term
Is respiratory depression associated with opioids?
Definition

YES! Respiratory depression caused by opioid overdose and can be fatal!

Term
Brand name for Fentanyl
Definition
Duragesic (CII)
Term
How long should the fentanyl patch be left on?
Definition
change patch Q3 days (ocassionally change Q48)
Term
If Fentanyl patche isn't dulling the pain, should they put on more patches?
Definition

No. Do not increase dose if pain is controlled but doesn't last long enough. In this case you shorten the interval

Term
What is fentanyl normally prescribed for?
Definition

Chornic pain management only!

 

Not used PRN and not used as initial opioid agent

Term
Does the Fentanyl patch work immediately?
Definition

Analgesic effect of patch can be seen 8-16 hours after application - do not stop other analgesic at first (decrease dose 50% for the first 12 hours)

 

[image][image][image][image]

Term

Fentanyl: Do not apply > 1 patch each time and do not heat up patch or skin area before applying. Do not cover with healing pad. Caution with fever (tell patient to call doctor if they have a fever). Do not cover with heating pads.

Definition
Statement. Not a question.
Term
How should Fentanyl patches be discarded?
Definition

Dispose patch in toilet or cut it up and put it in coffee grounds.

Term
Brand name for hydromorphone?
Definition
Dilaudid
Term
Brand name for Oxycodone?
Definition
(IR and CR) OxyContin
Term
Brand name for Oxycodone/APAP?
Definition

Endocet, Percocet, Roxicet

[image][image][image][image]

Term
Brand name for Oxymorphone?
Definition
Opana
Term
Should Oxymorphone be taken on an empty stomach?
Definition

Yes!

 

Term
Brand name for Mehtadone?
Definition
Dolophine
Term
Does Methadone have a liquid formulation?
Definition
Yes! (Methedose)
Term
Brand name for Meperidine?
Definition
Demerol
Term
Merperidine short or long acting?
Definition

SHORT duration of action (pain control for max 3 hours)

 

Obviously, do not use for chronic pain management

[image][image][image][image]

Term
[image]
Definition
Statement. Not a question.
Term
Brand  name for Hydrocodone + acetaminophen
Definition
Vicodin, Lortab
Term
Brand name for hydrocodone + acetaminophen
Definition
Tylenol #2, 3, 4
Term
Codeine used an antitusive is what schedule?
Definition
CV
Term

[image]

 

Definition
Statement. Not a question.
Term
Brand name for Tramadol?
Definition
Ultram, Ultram ER
Term
Brand name for Tramadol + Acetaminophen?
Definition
Ultracet
Term
Does tramadol affect seizure threshold?
Definition

Yes!

 

Term
[image]
Definition
Statement. Not a question.
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