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define narcotic
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Pharm 6
Opioid
| Question | Answer |
|---|---|
| define narcotic | |
| define miois | constrict pupils |
| define dysphoria | uneasy, anxiety |
| define antitussive | cough suppressant |
| key features of opiod | Act on the CNS to decrease reaction (response) to pain Physiologically addictive over time with regular use Used for moderate to severe pain |
| Briefly explain the mechanism of action of opioid analgesics | Bind to receptors in the CNS (brain and spinal cord) Alter reaction to pain |
| Identify 3 opioid receptors and explain their relationship to the pharmacologic effect and adverse reactions associated with opioids. | |
| mu | analgesia, respiratory depression, physical dependence, euphoria, sedation, constipation |
| kappa | analgesia, sedation, miosis, dysphoria |
| delta | analgesia |
| Identify different forms of administration for opioids | Opioids can be taken orally in tablet form or through a transdermal patch. Can be injected, snorted or smoked. Some in a nasal spray. |
| discuss the pharmacokinetics | Absorption Absorbed well orally Also absorbed from lungs, oral/nasal mucosa, and skin Distribution First-pass effect if taken orally Pass the placenta |
| What is the onset and duration of opiods | Onset =within 1 hr. Duration=4-6 hrs |
| discuss pharmacologic effects | Analgesia Sedation-at usual doses and additive effects with alcohol Euphoria- occurs at large does or if pain is removed Cough suppression- Gastrointestinal effects- reduces motility and contractions |
| Pharmacologic effects & adverse reactions related and proportional to drug strength | |
| Adverse reaction | respiratory depression cause vasodilation intercranial pressure nausea constipation miosis urinary retention xerostomia |
| if allergic to codeine, avoid | Morphine Hydromorphone (Dilaudid) Hydrocodone (Vicodin) Oxycodone (percodan, percocet) |
| how can opiods affect pregnancy | can be used May prolong labor or cause fetal respiration depression near term. |
| never get a tolerance to | pinpoint pupils constipation |
| what is the most potent opioid | hydromorphone (dilaudid) |
| Which opioid is most commonly used | morphine |
| list 5 strong analgesic | hydromorphone morphine methadone meperdine fentanyl |
| list intermediate analgesic | oxycodone |
| list 2 weak analgesic | hydrocodone codeine mixtures |
| high 1st pass effect most abused drug in medical personnel | merpidine (dermol) |
| Fentanyl combined with _____) allow a patient: to feel no pain remain awake will not move during a procedure (nasal intubation, bronchoscopy, cardiac catheterization) | Droperidol |
| Most used opioid in dentistry | codeine Combined with acetaminophen (Tylenol # 3) Used in cough syrup as antitussive |
| What schedule is a codeine alone? What schedule is a codeine mixture? | 2 3 for mixture |
| Used as replacement drug for heroin and other opioids Given to addicts orally Gradually weaned off Little euphoria Sufficient strength to prevent withdrawal symptoms It is also used for methadone maintenance | methadone |
| what schedule is tramadol (not as pain effective) | 4 |
| purpose of mixed opioids | used for treating addiction and pain |
| describe NALTREXONE | Used for treatment of addiction to opioids or alcohol Given orally |
| describe Naloxone (narcan) | Overdose treatment for opioids pure antagonist at all 3 receptors will competitively inhibit opioids Reverses CNS and respiratory depression Administered parenterally (injection/nasal) |
| List symptoms of opioid overdose how to treat? | Major symptom- respiratory depression Pinpoint pupils (miosis) Narcon |
| addiction | |
| Discuss ways to identify a drug addict | Requests a specific pain medication Cancels dental appointments because will be out of town for days but wants Rx Complains of pain for days after minor procedure Claims a low pain threshold Moves from office to office Needs refill with no pain |
| Identify symptoms associated with abrupt opioid withdrawal | Yawning Lacrimation Perspiration Rhinorrhea Goosebumps (piloerection) Nausea &vomiting Chills & tremors Tachycardia |
| Opioids are used in dentistry to manage pain if NSAIDS are contraindicated or not effective. Most dental pain can be managed with NSAIDS Not indicated for chronic dental pain due to addictive potential. | |
| Identify opioid related drugs that should be included on the emergency cart | Opioid overdose: -Naloxone (Narcan) Pain from a heart attack: -Morphine -Meperidine |
| Name the drugs associated with neuroleptanalgesia | droperidol+fentanyl |
| State the opioid and nonopioid components of the following: | |
| Percodan | aspirin+oxydone |
| Percocet | apap+oxycodone |
| Vicodin | |
| Tylenol #3 | apap+codeine |
| What does agonists treat? | pain, diarrhea, cough |
| What should you recommend an addict for pain relief? | NSAID |
Created by:
DH_Student