Opioid Antagonists & Toxicity
Nursing Process & Client Teaching for Analgesics
Histamine H_2 Receptor Antagonists
Proton Pump Inhibitors (PPIs)
Antacids & Mucosal Protective Agents
Nursing Process & Administration
100
This pure opioid antagonist rapidly reverses respiratory depression and sedation caused by opioid overdose.
What is naloxone (Narcan)?
100
This numeric scale (0 to 10) or visual analog scale should be utilized to assess pain severity both before and after medication administration.
What is the Pain Rating Scale (or Numeric Rating Scale / Wong-Baker FACES)?
100
This class of drugs works by competitively blocking histamine at 
receptors on these acid-producing cells in the stomach.
What are parietal cells?
100
Proton pump inhibitors end in this common drug suffix.
What is "-prazole" (e.g., omeprazole, lansoprazole)?
100
Unlike 
blockers or PPIs, antacids do not stop acid production; instead, they perform this chemical action on existing stomach acid.
What is neutralizing gastric acid?
100
To avoid drug interactions, antacids should generally be administered at least this many hours apart from other oral medications.
What is 1 to 2 hours?
200
The classic diagnostic triad of opioid toxicity consists of coma, respiratory depression, and this specific pupillary response.
What are pinpoint pupils (miosis)?
200
Outpatient education for patients taking combination analgesics containing acetaminophen (e.g., Percocet, Norco) must emphasize limiting total daily intake of acetaminophen below this maximum limit.
What is 3,000 to 4,000 mg (3–4 grams) per day?
200
Name two common 
receptor antagonist medications ending in the suffix "-tidine".
What are famotidine, cimetidine, or ranitidine?
200
PPIs suppress gastric acid secretion by blocking this enzyme system, often called the "proton pump," in parietal cells.
What is the hydrogen-potassium adenosine triphosphatase (
ATPase) enzyme system?
200
Aluminum-containing antacids commonly cause constipation, whereas magnesium-containing antacids frequently cause this adverse effect.
What is diarrhea?
200
Proton pump inhibitors like omeprazole should typically be administered at this time of day relative to meals.
What is 30 to 60 minutes before breakfast (before the first meal of the day)?
300
Because the duration of action of naloxone is often shorter than that of the opioid, nurses must closely monitor the patient for this critical safety event
What is recurrent respiratory depression (or re-sedation)?
300
To promote patient safety and prevent falls, nurses should instruct clients receiving opioid analgesics to call for assistance before doing this.
What is getting out of bed or ambulating?
300
: 
blockers are indicated for short-term treatment of active duodenal ulcers and this common condition caused by stomach acid flowing back into the esophagus.
What is GERD (Gastroesophageal Reflux Disease)?
300
PPIs are considered first-line therapy for severe GERD and erosive esophagitis because they are more powerful than this class of acid Reducers.
What are 
receptor antagonists (
blockers)?
300
Patients with chronic kidney disease should avoid magnesium- and aluminum-containing antacids due to the risk of this condition.
What is toxicity (or hypermagnesemia/electrolyte imbalance)?
300
Nurses should instruct patients on long-term acid suppression therapy to report severe, watery diarrhea, which may indicate an infection caused by this pathogen.
What is Clostridioides difficile (C. diff)?
400
Abrupt administration of an opioid antagonist to a physically dependent patient will trigger this uncomfortable clinical syndrome.
What is acute opioid withdrawal (abstinence syndrome)?
400
Patients prescribed oral salicylates or NSAIDs should be instructed to take their medication with food or milk to minimize this common adverse effect.
What is gastrointestinal distress / upset (or gastric irritation)?
400
When administering 
antagonists to elderly clients or those with hepatic impairment, nurses must monitor for these central nervous system side effects.
What are confusion, dizziness, or hallucinations?
400
Long-term use of proton pump inhibitors increases the patient's risk for bone fractures due to impaired absorption of this essential mineral.
What is calcium?
400
This mucosal protectant forms a viscous, gel-like barrier over ulcer sites to protect them from acid and pepsin.
What is sucralfate?
400
Sucralfate should be administered on an empty stomach at this specific timing relative to meals.
What is 1 hour before meals and at bedtime?
500
Unlike pure antagonists, mixed opioid agonist-antagonists (like pentazocine or buprenorphine) exhibit this phenomenon, limiting their maximum analgesic effect while lowering the risk of severe respiratory depression.
What is a ceiling effect?
500
When evaluating a client on a Patient-Controlled Analgesia (PCA) pump, the nurse must ensure that only this individual presses the dosage button.
What is the patient (client)?
500
Cimetidine should be used with extreme caution because it inhibits liver enzymes, leading to an increased risk of toxicity with this specific antidiabetic medication or blood thinner.
What is metformin (or warfarin)?
500
PPIs are a core component of triple-therapy regimens used to eradicate this gastrointestinal bacterial infection.
What is Helicobacter pylori (H. pylori)?
500
Misoprostol, a synthetic prostaglandin used to prevent NSAID-induced ulcers, is strictly contraindicated in pregnant patients for this reason.
What is inducing uterine contractions (causing miscarriage/abortion)?
500
When assessing a patient with suspected peptic ulcer disease, the nurse knows that pain occurring 2 to 3 hours after meals and relieved by food is characteristic of this type of ulcer.
What is a duodenal ulcer?