Term
| what are the withdraw symptoms of opioids? |
|
Definition
Anxiety Chills Hyperventilation Hyperthermia Hostility Lacrimation Muscle Aches Mydriasis piloerection rhinorrhe Vomiting/Diarrhea Yawning |
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Term
| what are the uses for opioids? |
|
Definition
ANALGESIA anesthesia acute pulmonary embolism cough diarrhea shivering |
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Term
| what are the main SEs for opioids? |
|
Definition
constipation itching mental clouding/confusion nausea/vomiting respiratory distress sedation urinary retention |
|
|
Term
| which 2 opioids are used to treat acute pain, chronic pain and cancer pain? |
|
Definition
Morphine Fentanyl they are both Preg. C and Class 2 |
|
|
Term
| what should avoid using with fentanyl? |
|
Definition
|
|
Term
| what are some additional SEs that Fentanyl causes? |
|
Definition
cough insomnia wt loss ~10% rigidity and mm aches |
|
|
Term
| what unique form does fentanyl come in? |
|
Definition
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|
Term
| which opioids do you use for mild to moderate pain? |
|
Definition
codeine propoxyphene tramadol |
|
|
Term
| besides using codeine for mild to moderate pain, what else can it be used to treat? |
|
Definition
|
|
Term
| which of the drugs used to treat mild to moderate pain has been shown to not be of much use and is so easily obtained it is often used in suicides? |
|
Definition
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|
Term
| what are some things you need to look out for when using tramadol? |
|
Definition
do not use in a pt with severe hepatic disease do not used ER in renal pts can cause N/V, dizziness and seizures (also its a weak mu agonist) |
|
|
Term
| which opioids are used to treat moderate to severe pain? |
|
Definition
hydrocodone hydromorhpone meperidine oxycodone oxymorphone |
|
|
Term
| which opioid used for moderate to severe pain is assc with drug dumping when alcohol is used? |
|
Definition
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|
Term
| which opioid drug used for chronic pain, cancer pain and acute pain is assc with drug dumping when the patch form is used? |
|
Definition
|
|
Term
| which opioid used for moderate to severe pain is class 3 and which is preg B? |
|
Definition
|
|
Term
| which opioid is a prodrug of morphine? |
|
Definition
|
|
Term
| which other drug do you need to be especially careful with when its combined hydrocodone? |
|
Definition
acetaminophen (combo is Vicoden) becomes toxic at >4 g/d |
|
|
Term
| which opioid used for mod to severe pain has a toxic metabolite? |
|
Definition
meperidine (also can't be used with MAOIs) |
|
|
Term
| what are some additional SEs assc with meperidine? |
|
Definition
agitation mm jerks seizures hypotension at high doses |
|
|
Term
| what are the contraindications for all opioids? |
|
Definition
| Head Injury - increased ICP Pregnancy - can have an addicted baby Impaired pulmonary function Endocrine disease Hepatic / Renal failure |
|
|
Term
| which opioid used for mild to moderate pain has been assc with an increase in seizures? |
|
Definition
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|
Term
| which opioid used to treat moderate to severe pain is also used to treat obstetric pain, anxiety and used as an anesthetic? |
|
Definition
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|
Term
when is it best to take oxymorphone? who should not take it? |
|
Definition
on an empty stomach (50% more is released w/ food) kids, those with mod-sev hepatic disease |
|
|
Term
| which opioid is used to treat chronic pain, cancer pain, opioid withdrawl (including heroin) and neuropathic pain? |
|
Definition
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|
Term
| what additional SEs can methadone cause? |
|
Definition
sweating high doses can cause prolonged QT intervals and cardiac arrhythmias |
|
|
Term
| which two drugs should be avoided when using methadone? |
|
Definition
rifampin phenytonin may cause withdrawl |
|
|
Term
| which opioid has derivatives and what are they? |
|
Definition
fentanyl sufentanil remifentanil (used in short painful procedure, post op and has a more rapid onset) |
|
|
Term
| which drugs are opioid antagonists? |
|
Definition
naloxone alvimopan methylnaltrexone |
|
|
Term
| which opioid antagonists are used to treat constipation caused by opioids? |
|
Definition
|
|
Term
| what preg categories are the opioid antagonists? |
|
Definition
naloxone - C alvimopan - B methylnaltrexone - B |
|
|
Term
| which opioid antagonist is used a lot in code situations? |
|
Definition
naloxone for drug OD, opioid AEs/reversal |
|
|
Term
| which opioid antagonist is used to treat post op ileus? |
|
Definition
|
|
Term
| when is methynaltrexone indicated? |
|
Definition
| only in advanced illness, pallative care and when other laxatives have failed |
|
|
Term
| what are the additional SEs of methylnaltrexone and alvimopan? |
|
Definition
methyl - abd pain, NVD, dizziness Alv - constipation, flatulence, back pain, hypokalemia, urinary retention |
|
|
Term
| which 2 opioids should not be used with MAOIs? |
|
Definition
|
|
Term
| What is the MOA of opioids? |
|
Definition
bind to opioid receptors (mainly mu) in the CNS 1. inhibits transmission of nociceptive input 2. activates descending inhibitory pathways 3. alters limbic activity (opens K channels which hyperpolarizes it) |
|
|
Term
| which opioids should not be used in kids? |
|
Definition
|
|
Term
| which opioid is good for using long term at home? |
|
Definition
|
|
Term
| what problem did alvimopan cause in high doses? (doses no longer used anymore) |
|
Definition
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