1. Analgesics are drugs that
    relieve pain without causing loss of consciousness.
  2. Opioid
    a general term defined as any drug, natural or synthetic, that has actions similar to those of morphine.
  3. Narcotic
    has been used to mean an analgesic, a central nervous system (CNS) depressant, and any drug capable of causing physical dependence.

    Opiod is the better Term
  4. What are the main classes of opioid receptors

  5. At each type of receptor, a drug can act in one of three ways:
    as an agonist, partial agonist, or antagonist.
  6. Drugs that bind opioid receptors fall into three major groups:
    • (1) pure opioid agonists,
    • (2) agonist-antagonist opioids,
    • (3) pure opioid antagonists.
  7. Opioids are the most effective
    analgesics available
  8. Morphine and other pure opioid agonists relieve
    pain by mimicking the actions of endogenous opioid peptides.
  9. Morphine has multiple pharmacologic effects:
    • oAnalgesia
    • oSedation
    • oRespiratory depression
    • oCough suppression
    • oSuppression of bowel movements
  10. Opioid-induced sedation and euphoria can complement
    pain relief
  11. Because opioids produce euphoria and other desirable subjective effects, they have a
    high liability for abuse.
  12. Opiods' principal indication is
    relief of moderate to severe pain.
  13. What is the most serious adverse effect of an opioid
    Respiratory Depression
  14. Other important adverse effects of Opioids are
    • constipation,
    • urinary retention,
    • orthostatic hypotension,
    • emesis,
    • elevation of intracranial pressure (ICP).
  15. Morphine is administered by several routes
    • oral, intramuscular (IM),
    • intravenous (IV),
    • subcutaneous (subQ),
    • epidural,
    • intrathecal.
  16. Morphine must be able to cross the
    blood-brain barrier to relieve pain.
  17. oral doses of morphine must be______than parenteral doses to produce ______

    equivalent analgesic effects.
  18. Because the blood-brain barrier is poorly developed in infants, these patients need
    smaller doses of opioids (adjusted for body weight) than do older children and adults.
  19. With prolonged opioid use
    tolerance develops to analgesia, euphoria, sedation, and respiratory depression

    but NOT to constipation and miosis.
  20. With prolonged opioid use what kind of tolerance develops
    Physical tolerance
  21. withdrawal syndrome associated with opioids, although unpleasant is ....
    is not dangerous.
  22. To minimize symptoms of abstinence, opioids should be
    withdrawn gradually
  23. Precautions to opioid use include
    pregnancy, labor and delivery, head injury, and decreased respiratory reserve.
  24. Patients taking opioids should avoid
    alcohol and other CNS depressants

    because these drugs can intensify opioid-induced sedation and respiratory depression.
  25. Patients taking opioids should avoid what kind of drug
    anticholinergic drugs (eg, antihistamines, tricyclic antidepressants, atropine-like drugs)

    because these drugs can exacerbate opioid-induced constipation and urinary retention.
  26. Opioid overdose produces a classic triad of signs which are
    coma, respiratory depression, and pinpoint pupils.
  27. All strong opioid agonists are essentially equal to
    morphine with regard to analgesia, abuse liability, and respiratory depression.
  28. Fentanyl is available in______formulations for administration by_____Routes

    • Three routes
    • parenteral, transdermal, and transmucosal.
  29. The advantage of fentanyl is
    in its many routes
  30. Use of meperidine (Demerol) should not exceed_____hours
    48 hours

    to avoid accumulation of normeperidine, a toxic metabolite.
  31. Like morphine, codeine and other moderate to strong opioid agonists produce
    analgesia, sedation, euphoria, respiratory depression, constipation, urinary retention, cough suppression, and miosis
  32. Codeine and other moderate to strong opioid agonists differ from morphine in that they produce
    less analgesia and respiratory depression and have a lower potential for abuse.
  33. The combination of codeine with a nonopioid analgesic (eg, aspirin, acetaminophen) produces
    greater pain relief than can be achieved with either agent alone.
  34. Most agonist-antagonist opioids act as
    agonists at kappa receptors

    and antagonists at mu receptors.
  35. Pentazocine and other agonist-antagonist opioids produce
    less analgesia than morphine and have a lower potential for abuse.
  36. As a rule, opioids should be administered on a
    fixed schedule (with supplemental doses for breakthrough pain) rather than as needed (PRN).
Card Set
key points from book