Pain
what are the two broad categories for pain relief?
opioids and nonopioids
opioids are used to relieve what type of pain?
moderate to severe
prototype is what?
morphine
this is a method of drug delivery that uses an infusion pump to deliver a prescribed amount of opioid by patient self-administration, what is this called?
patient controlled analgesia (PCA)
what is the prototype for opioid agonist-antaonist?
butorphanol
There is a third category of pain control medication, what is this one called?
adjuvant analgesics
opioids exert actions by interacting with these opioid receptors in the CNS, what are these called?
Mu
Kappa
what is the treatment for an over dose?
naloxone
when you start a patient on a PCA, you would give them this type of dose?
loading
opioid agonist-antagonists can be used not only for moderate pain, anesthesia adjunct but also used during this, what is this?
pain relief during labor and delivery
what determines, factors, the type of pain control medication you may use for your patient?
severity of pain
potential adverse effects
drug interactions
contraindications
there are 3 categories of opioids: what are the categories:
1. this reacts with both mu and kappa receptors
2. this stimulates certain opioid receptors but blocks others
3. binds to both mu and kappa receptors but does not activate them
1. opioid agonists
2. mixed opioid agonist-antagonist
3. opioid antagonists
what is the syndrome that occurs with abrupt discontinuation of opioid use?
abstinence syndrome
there are preset amounts of drug that are allowed, these doses are given when the patient presses the button, this is considered what type of dose?
bolus
what is the MOA for opioid antagonist?
binds strongly to opioid receptors but do NOT activate them
Adjuvant analgesics are a diverse group of drugs that are used to enhance analgesia for specific indications, what are some of the other primary classifications?
antidepressants, antiseizure, tranquilizer or anti inflammatory
prior to giving opioid agonist, when assessing respiratory depression, how many respirations/minute would you hold the medication?
12
during an emergency overdose look for what?
respiratory depression
pinpoint pupils
unconsciousness
the time period that controls the amount of medication that can be delivered is called the what?
lock out period
what is the prototype for this?
naloxone
The controlled sustance act of 1970 ranks drugs by their potential for abuse by placing them in how many categories?
1-5
What is the black box warning for opioids?
potential for abuse, resp. depression, prolonged use during pregnancy can result in neonatal abstinence syndrome
due to the constipating effect of opioids what education would you give your patients?
encourage fluids and fiber as well as stool softener/laxatives if needed
what medication is given to a NAS baby to wean them off drugs their mothers were dependent on?
methadone
what drugs effects will not be relieved by naloxone?
sedative/hypnotic, antianxiety, antipsychotics