Term
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Definition
| drugs that bind well to a receptor |
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Term
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Definition
| binds to a receptor, but the response is limited (i.e. is not as great as with the agonist) |
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Term
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Definition
has properties of both the agonist and antagonist.
antagonists- bind to a receptor and cause no response, can reverse the effects of the agonist. |
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Term
| opiates are natural substances obtained from raw ______ |
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Definition
opium.
they include: morphine sulfate, codeine, hydrochlorides of opium alkaloids, & camphorated tincture of opium. |
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Term
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Definition
those manufactured analgesics with properties and actions similar to the natural opiods.
ex: methadone, levorphanol, remifentanil, meperidine. |
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Term
| cells in the central nervous system (CNS) have receptor sites called _______ |
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Definition
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Term
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Definition
| used primarily for treatment of moderate to severe acute and chronic pain and in the treatment/management of opiod dependence |
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Term
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Definition
CNS reactions:
euphoria, weakness, headache
lightheadedness, dizziness, tremor
miosis, insomnia, agitation, tremor
increased intercranial pressure, imapairment of mental and pysical tasks |
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Term
| adverse reaction (respiratory) |
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Definition
| depression of rate and depth of breathing |
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Term
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Definition
nausea, vomiting
dry mouth, biliary tract spasms
constipation, anorexia |
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Term
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Definition
facial flushing
tachycardia, bradycardia, palpitations
peripheral circulatory collapse |
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Term
| adverse reaction (genitourinary) |
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Definition
urinary retention or hesitancy
spasms of the ureters and bladder sphincter |
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Term
| adverse reaction (allergies, etc) |
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Definition
pruritis, rash, urticaria
sweating, pain at injection site and local tissue irritation |
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Term
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Definition
known hypersensitivity to the drugs.
in pts with acute bronchial asthma, emphysema, or upper airway obstruction, & in pts with head injury or increased intracranial pressure.
in pts w/convulsive disorders, severe renal or hepatic dysfunction, & acute ulcerative colitis. |
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Term
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Definition
C drugs and are not recomended for use during pregnancy/labor bc they may prolong labor/cause respiratory depression in the neonate.
(oxycodone is in pregnancy category B) |
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Term
interacting drug:
alcohol (common use: social occasions)antihistamines (use: prevent or relieve allergic reaction)
antidepressants (use:alleviate depression)
sendatives (sedation)
phenotiazines (refliefe of agitation, anxiety, vomiting) |
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Definition
| effect of interaction: increased risk for CNS depression |
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Term
interacting drug:
opiod agonist-antagonist (use:gynecologic or obstetric pain) |
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Definition
effect:
opiod withdrawal symptoms (if long-term opiod use) |
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Term
interacting drug:
barbiturates (use: in general anesthesia) |
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Definition
effect:
respiratory depression, hypotension, or sedation |
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Term
HERBAL ALERT:
Passion Flower |
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Definition
used in medicine to treat pain, anxiety and insomnia.
herbalists use to treat symptoms of parkinsonism.
no adverse reactions reported, large doses may cause CNS depression.
contraindicated in pregnancy & pts taking MAOI.
contains coumarin; risk of bleeding may be increased in pts taking warfarin(coumadin) |
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Term
| preadministration assessment |
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Definition
assess and document: type, onset, intensity, location of pain.
document description of pain and estimate of when pain began.
nurse reviews pts health history, allergy history, past/current drug therapies-- espicially important when opiod is given for 1st time bc data may be obtained during initial history & physical assessment that require nurse to contact PCP. further questioning necessary, PCP may change mind to administer a specific opiod drug.
if promethazine (phenergan) is used, the nurse should take BP, pulse & respiratory rate before giving drug. |
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Term
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Definition
obtain BP, pulse, respirations, pain rate in 5-10 min given IV.
20-30 min given IM or subq.
30 min or more given PO.
ask about pain regularly and believe pt and family in their reports.
opiod niave pt who does not use opiods routinely is at greater risk for respiratory depression in pt who is vulnerable. if pt resp rate is 10 breaths/min, nurse monitors at more frequent intervals and notifies PCP immediately.
when opiate is used as an antidiarrheal drug, nurse records each BM, appearance, color and consistancy. nurse should notify PCP immediately if diarrhea is not relieved or becomes worse, pt has severe abdominal pain or if blood in stool is noted. |
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Term
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Definition
Ineffective Breathing Pattern related to pain and effects on breathing center opiods.
Risk For Injury related to dizziness or lightheadedness from opiod administration.
Constipation related to decreased GI motility.
Imbalanced Nutrition: Less than Body Requirements related to anorexia caused by opiods. |
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Term
| LIFESPAN ALERT: Gerontology |
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Definition
| transdermal route should be used with caution in elderly, bc amount of subcutaneous tissue is reduced in the aging process. Transdermal route of drug is used bc it treates severe pain most effectively and should not be used simply for the convenience of administration. |
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Term
NURSING ALERT:
Drop in resp. rate |
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Definition
| the nurse should attempt to increase the rate by coaching pt to breathe. if antidote needed, naloxone (narcan) should be administered with great caution and only necessary in pt rec opiod for severe pain. Naloxon removes all of the pain relieving effects of opiod and may lead to withdrawal symptoms or the return of intense pain. |
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Term
NURSING ALERT:
Epidural analgesia |
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Definition
| should be adminstered only by those specifically trained in the use of IV and epidural anesthetics. Oxygen, resuscitative, and intubation equipment should be readily available. |
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Term
NURSING ALERT:
transfering from levamethadyl to methadone |
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Definition
| nurse should wait 48 hours after last dose of levamethadyl before administering first dose of methadone or other opiod. |
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Term
| Educating the patient and family: |
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Definition
nurse informs pt that the drug receiving is for pain. include info such as how often the drug can be taken and the name of the drug.
If PCA infusion pump is being used, nurse teaches pt how to use machine during preoperative period rather than waiting until the paitent is in pain in the post operative unit. nurse notifies PCP if pt does not understand PCA procedure so alternative method of pain relief is ordered.
Includ following points in teaching plan:
drug may cause dizziness, drowsiness, blurring of vision. use with caution when driving or performing tasks that require alertness.
avoid use of alcoholic beverages unless use has been approved by PCP. use of alcohol and an opiod can have extremely serious and even life-threatening consequences.
take drug as directed and do not exceed prescribed dose, contact PCP if drug is not effective.
if GI upset occurs, take with food.
notify PCP if nausea, vomiting and constipation become severe. |
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