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ANAlgesic (opioids)
Pharm 2025
| Question | Answer |
|---|---|
| Analgesic USE: | moderate to severe pain |
| Analgesic MoA: | binds to opioid receptors in CNS to block pain signals blocks pain transmission alters perception of pain |
| Analgesic side affects: | RR depression, sedation, constipation, hypotension |
| Analgesic medication options: | Morphine, Hydromorphone, fentanyl, codeine |
| Analgesic Nurse Tips: | Monitor respiration <12 hold medication, avoid alcohol/CNS depressants, fall risk (ambulation assistance) |
| Analgesic therapeutic use: | post op pain, cancer pain, and MI pain Palliative care |
| Analgesic side effects: | miosis (pinpoint pupils/toxicity), urinary retention, orthostatic hTN, nausea and vomiting |
| Analgesic BLACK BOX WARNING | high potential for addiction, abuse, and misuse life threatening respiratory depression |
| Analgesic special consideration: | codeine is weaker used as a cough suppressant Methadone long half life -- used for detox from opioids |
| Analgesic routes and strength | IV: faster (acute), Transdermal patch - slow onset. oral: longer acting (chronic) |
| Analgesic Mnemonics | ABC: assess pain, breathing rate, and constipation assess |
| Analgesic TX: | naloxone (narcan) |
| Pathophysiology of Opioid Analgesics | From the injury site (peripheral nociceptors) → to the spinal cord (dorsal horn) → then up to the brain (thalamus & cortex) where they’re perceived as pain |
| Pathophysiology: Where Opioids Act | BPS (Brain peripheral nerves and spinal) - BPs Peripheral nerves Spinal cord (substantia gelatinosa) Brain (limbic system, thalamus, cortex) |
| Pathophysiology: opioid receptors: Mu (μ) – | primary receptor for pain relief, but also causes respiratory depression, euphoria, and physical dependence receptors are throughout the CNS and GI tract, |
| Pathophysiology: opioid receptors: Kappa (κ) | spinal analgesia, sedation |
| Pathophysiology: opioid receptors: Delta (δ) | less understood, also modulates pain |
| Pathophysiology: opioids bind to receptors: | They slow transmission of the pain signal from periphery to brain → Result: Decreased perception of pain |
| Pathophysiology: opioids bind to receptors: | They hyperpolarize neurons, making them less likely to fire → Result: Decreased perception of pain |
| Pathophysiology: opioids bind to receptors: | They inhibit the release of substance P and other neurotransmitters that transmit pain → Result: Decreased perception of pain |
| Pathophysiology: WHY constipation? | Suppress respiratory center in the medulla → respiratory depression Act on brain reward centers → euphoria, dependence Slow GI motility → constipation Stimulate chemoreceptor zone → nausea Cause histamine release → itching, hypotension |
| Pathophysiology: Summary of Opioids: | Opioids block pain by binding to CNS receptors and stopping pain signals from being sent or perceived—while also causing wide CNS and GI side effects. |
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