Pharm-Opioid Analgesics

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  1. Prototype for opiates
  2. What is the physiology of pain?
    • Injury > Arachidonic Acid >Cyclooxygenase > prostaglandins (Vasodilation) > Activating Pain receptors
    • or
    • Injury > Bradykinin (Vasodilation) > Activating Pain Receptors
  3. What is exogenous pain relief
    Things we take in to relieve pain
  4. What is endogenous pain relief
    • System of opioid peptides: endorphins, seratonin, GABA
    • Things our body can do to relieve pain
  5. What are the two types of pain we look for?
    • Duration:Acute, Chronic¬†
    • Origin: Somatic
    • Visceral
    • Neuropathic
  6. What to look for during pain assessment
    • location
    • relation to time, activity
    • precipitates/provokes
    • pain scale
    • other
    • quality
    • radiation
    • severity
    • timing
  7. What are the 3 categories of pain management?
    • Opiates/Opioids
    • Non-Opiates: Acetaminophen, Salicylates, NSAIDs
    • Adjuvant: Benzodiazepine, TCA, Corticosteroids
  8. What is the therapeutic effect of opiates?
    interferes with pain impulses thereby decreasing pain
  9. What are the ADE of Opiates?
    • Depresses CNS: decreases respiratory rate, sedation, dizziness
    • Depress GI Tract: N/V, Constipation
    • Alters psychological response to pain
    • produces Euphoria
  10. What are the route of administration for Opiates?
    • PO
    • IV
    • Patch
    • PCA (Patient Controlled Analgesia)
  11. What is common clinical use for opiates?
    • Severe-Moderate pain relief
    • acute pulmonary edema
    • severe non-productive cough (CODEINE, ANTITUSSIVE)
  12. What's an antitussive?
    cough suppressant (codeine)
  13. When do you use opiates cautiously?
    • pt has respiratory depression
    • Chronic lung disease
    • kidney or liver failure
    • increased intracranial pressure
  14. What are infrequent uses for opiates?
    • invasive diagnostic test
    • pre-op sedation
    • labor and delivery
  15. What is an opiate antagonist?
    • Naloxone (Narcan)
    • counteracts opiates by binding to opiate receptors
    • *Not a CNS stimulant*
  16. What is important for a drug user when administering an opiate antagonist?
    monitor for withdrawal symptoms
  17. Agonist/Antagonist prototype
    pentazocine (talwin)
  18. When is it considered opiate abuse?
    When it is being used for mind-altering
  19. What are some symptoms of opiate abuse?
    • decreased CNS
    • nodding head
    • myosis (constricted pupils)
    • slurred speech
    • decreased HR
    • decreased Resp
  20. What are treatments for opiate abusers?
    • Bupienorphine (suboxone)
    • Methadone

    will still be addicted, but will be more productive
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Pharm-Opioid Analgesics
Opioid Analgesics
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