Opioid Analgesics (meperidine, fentanyl, methadone, morphine, oxycodone)

When an opioid overdose occurs, what medication should be administered?

Naloxone

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Opioid analgesics are further classified by their mechanism of action of *AGONISTS* which bind to opioid pain receptors in the CNS to *ALTER AND REDUCE* the sensation of pain.

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When patients experience respiratory depression or overdose from opioid *AGONISTS*, an opioid *ANTAGONIST* needs to be administrated, which include naloxone and naltrexone.

What is the main action of opioids?

Bind to opioid pain receptors in the CNS to alter and reduce the sensation of pain

Indications of use for opioids include which of the following? Select all that apply.

*Cough center suppression *Diarrhea *Treat moderate to severe pain

Opioid education should include which of the following? Select all that apply.

*Maintain adequate fluid and fiber intake to prevent constipation *Monitor respiratory rate and call prescriber immediately if it is less than 10 breaths per minute or with any difficulty breathing *Change positions slowly to prevent orthostatic hypotension *Keep a record of pain experience and treatment response

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*PHYSICAL DEPENDENCE* is when the body adapts to the presence of the opioid

Which of the following are adverse effects of opioids? Select all that apply.

*Respiratory depression *Constipation *CNS depression

Opioids are contraindicated with which of the following conditions? Select all that apply.

*Severe asthma *Known drug allergy

Caution should be taken in giving opioids to which of the following patient conditions? (Select all that apply)

*Sleep apnea *History of opioid addiction *Respiratory insufficiency *Elderly

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*TOLERANCE* of/to opioids occurs when larger doses are required to maintain the same drug effect.

1. When there is compulsive opioid use and continual craving and need for effects outside of pain relief, (psychologic dependence). 2. When larger doses are required to maintain the same opioid effect. 3. When the body adapts to the presence of the opioid.

1. Addiction 2. Tolerance 3. Physical Dependence

1. May cause paradoxical reactions, particularly with Meperidine. 2. May cause opioid withdrawal for dependent patients. 3. May cause an increase in CNS depressant properties. 4. May decrease the analgesic effects of the opioid analgesic.

1. MAO inhibitors and procarbazine 2. partial-antagonist opioid analgesics 3. Alcohol, antihistamines, antidepressants, sedative/hypnotics, phenothiazines and MAO inhibitors 4. Nalbuphine

1. Meperidine 2. Fentanyl 3. Methadone 4. Morphine 5. Oxycodone

1. Synthetic opioid -Typically used for migraines and post-operative shivering -Active metabolite (normeperidine) can accumulate when it reaches toxic levels, therefore not recommended for long-term pain management 2. Synthetic opioid -Used for long-term pain management -Patches should not be used for acute post-operative pain management -Used to supplement general anesthesia 3. Synthetic opioid -Detoxifying patients addicted to methadone -Used for neonate abstinence syndrome caused by mothers taking methamphetamine during pregnancy 4. Natural opioid derived from the opium poppy plant -Used for pulmonary edema and pain from a myocardial infarction (MI) 5. Semi-synthetic opioid structurally related to morphine -Weaker than other opioids and is often used in combination with acetaminophen for moderate to severe pain. -Used for long-term pain management.

Opioids are classified under which of the following related to their mechanism of action?

Agonists

The therapeutic effect of opioid analgesics is which of the following?

Analgesia