NUR2474 Pharmacology Module 8 Quiz Review
NUR2474 Pharmacology Module 8 Quiz Review
Tips: There will be a number of negatively worded questions. Please be mindful of that.
Topics review:
1. Physical dependence vs addiction with opiate use
a. Tolerance
i. Increased doses needed to obtain the same response
ii. Develops with analgesia, euphoria, sedation, and respiratory depression
iii. Cross-tolerance to other opioid agonists
iv. No tolerance to miosis or constipation develops
b. Physical dependence
i. Abstinence syndrome with abrupt discontinuation
ii. About 10 hours after last dose, the initial reaction occurs and includes yawning,
rhinorrhea, and sweating
iii. Progresses to violent sneezing, weakness, nausea, vomiting, diarrhea,
abdominal cramps, bone and muscle pain, muscle spasms, and kicking
movements
iv. Lasts 7 to 10 days if untreated
v. Withdrawal is unpleasant but not lethal, as it may be with CNS depressants
vi. Patients dependence does not mean addiction
vii. Short-term use does not lead to dependence
viii. If used as prescribed, it does not lead to dependence.
1. Wean patient of medication slowly, and they will be fine.
c. It is not common for patients to abuse opioids
2. PCA pump patient family education
a. Educate family members not to operate the PCA pump, even if patient seems to be in
pain.
b. ONLY PATIENT USES PUMP!
3. Antidote for opiates
a. Naloxone
i. Reversal of opioid overdose
1. Drug of choice with pure opioid agonist overdose
2. Titrated cautiously with physical dependence
ii. Reversal of postoperative opioid effects
1. Titrated to achieve adequate ventilation and to maintain pain relief
iii. Reversal of neonatal respiratory depression
1. Opioids given during labor and delivery may cause respiratory
depression in neonate
b. Methylnaltrexone
i. Selective opioid antagonist
ii. Treatment of opioid-induced constipation in late-stage disease for patients
, receiving constant opioids
iii. Block mu opioid receptors in the gastrointestinal tract
4. Foley catheter use in patients on PCA pump
a. An adverse effect of patients of opioids is urinary retention.
i. Foley catheter may be required.
b. Other pharmacologic actions
i. Respiratory depression
ii. Constipation
iii. Orthostatic hypotension
iv. Emesis
v. Miosis
vi. Cough suppression
vii. Biliary colic
viii. Tolerance and physical dependence
5. Diphenhydramine vs non-drowsy allergy meds
a. DROWSY—First generation H1
i. Produce selective blockade of H1 receptors
ii. Used for treatment of mild allergic disorders
iii. Diphenhydramine (Benadryl)
1. Highly sedating
iv. Block the actions of histamine at H1 receptors
v. Do not block H2 receptors
vi. Some bind to muscarinic receptors
vii. Talk to doctor if concerned about sedative effect, can change to second
generation antihistamine which have less or no sedative effect.
b. Non-drowsy allergy meds second generation
i. Produce selective blockade of H2 receptors
ii. Used for treatment of gastric and duodenal ulcers
iii. Not used for treatment of allergies
iv. Produce much less sedation than first-generation agents
v. Cross the blood-brain barrier poorly
vi. Have a low affinity for H1 receptors of the CNS
vii. Largely devoid of anticholinergic actions
c. Second Gen with slight drowsiness
i. Cetirizine (Zyrtec)
1. Uses: Allergic rhinitis and chronic idiopathic urticaria
2. Food delays absorption
3. More sedating than other second-generation antihistamines but less
sedating than first-generation drugs
ii. Levocetirizine (Xyzal)
1. Uses: Allergic rhinitis and chronic idiopathic urticaria
2. More sedating than other second-generation antihistamines but less
sedating than first-generation agents
3. Most common side effects: Drowsiness, fatigue, muscle weakness, dry
mouth
4. Avoid alcohol and other CNS depressants
NUR2474 Pharmacology Module 8 Quiz Review
Tips: There will be a number of negatively worded questions. Please be mindful of that.
Topics review:
1. Physical dependence vs addiction with opiate use
a. Tolerance
i. Increased doses needed to obtain the same response
ii. Develops with analgesia, euphoria, sedation, and respiratory depression
iii. Cross-tolerance to other opioid agonists
iv. No tolerance to miosis or constipation develops
b. Physical dependence
i. Abstinence syndrome with abrupt discontinuation
ii. About 10 hours after last dose, the initial reaction occurs and includes yawning,
rhinorrhea, and sweating
iii. Progresses to violent sneezing, weakness, nausea, vomiting, diarrhea,
abdominal cramps, bone and muscle pain, muscle spasms, and kicking
movements
iv. Lasts 7 to 10 days if untreated
v. Withdrawal is unpleasant but not lethal, as it may be with CNS depressants
vi. Patients dependence does not mean addiction
vii. Short-term use does not lead to dependence
viii. If used as prescribed, it does not lead to dependence.
1. Wean patient of medication slowly, and they will be fine.
c. It is not common for patients to abuse opioids
2. PCA pump patient family education
a. Educate family members not to operate the PCA pump, even if patient seems to be in
pain.
b. ONLY PATIENT USES PUMP!
3. Antidote for opiates
a. Naloxone
i. Reversal of opioid overdose
1. Drug of choice with pure opioid agonist overdose
2. Titrated cautiously with physical dependence
ii. Reversal of postoperative opioid effects
1. Titrated to achieve adequate ventilation and to maintain pain relief
iii. Reversal of neonatal respiratory depression
1. Opioids given during labor and delivery may cause respiratory
depression in neonate
b. Methylnaltrexone
i. Selective opioid antagonist
ii. Treatment of opioid-induced constipation in late-stage disease for patients
, receiving constant opioids
iii. Block mu opioid receptors in the gastrointestinal tract
4. Foley catheter use in patients on PCA pump
a. An adverse effect of patients of opioids is urinary retention.
i. Foley catheter may be required.
b. Other pharmacologic actions
i. Respiratory depression
ii. Constipation
iii. Orthostatic hypotension
iv. Emesis
v. Miosis
vi. Cough suppression
vii. Biliary colic
viii. Tolerance and physical dependence
5. Diphenhydramine vs non-drowsy allergy meds
a. DROWSY—First generation H1
i. Produce selective blockade of H1 receptors
ii. Used for treatment of mild allergic disorders
iii. Diphenhydramine (Benadryl)
1. Highly sedating
iv. Block the actions of histamine at H1 receptors
v. Do not block H2 receptors
vi. Some bind to muscarinic receptors
vii. Talk to doctor if concerned about sedative effect, can change to second
generation antihistamine which have less or no sedative effect.
b. Non-drowsy allergy meds second generation
i. Produce selective blockade of H2 receptors
ii. Used for treatment of gastric and duodenal ulcers
iii. Not used for treatment of allergies
iv. Produce much less sedation than first-generation agents
v. Cross the blood-brain barrier poorly
vi. Have a low affinity for H1 receptors of the CNS
vii. Largely devoid of anticholinergic actions
c. Second Gen with slight drowsiness
i. Cetirizine (Zyrtec)
1. Uses: Allergic rhinitis and chronic idiopathic urticaria
2. Food delays absorption
3. More sedating than other second-generation antihistamines but less
sedating than first-generation drugs
ii. Levocetirizine (Xyzal)
1. Uses: Allergic rhinitis and chronic idiopathic urticaria
2. More sedating than other second-generation antihistamines but less
sedating than first-generation agents
3. Most common side effects: Drowsiness, fatigue, muscle weakness, dry
mouth
4. Avoid alcohol and other CNS depressants
