UTA PHARM - EXAM 2 MAJOR CONCEPT QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
Analgesics Ans✓✓✓
Opioid Analgesics Ans✓✓✓There are 3 different classifications of
chemical structures for opioid analgesics.
1. morphine-like drugs;
2. meperidine-like drugs,
3. methadone-like drugs.
analgesics:
•Codeine, fentanyl, hydromorphone, meperidine, methadone, morphine,
oxycodone
-Fentanyl is 100x more potent than morphine and is dosed in mcg,
-Hydromorphone is 7x more potent than morphine
-pain and cough(codeine)
-
•Use caution: head injury, respiratory insufficiency, morbid obesity,
sleep apnea, pregnancy
-
•Side effects: Constipation, nausea, vomiting, sedation and mental
clouding, respiratory depression, dry mouth, urinary retention, pruritis,
dysphoria, euphoria, bradycardia, and hypotension
,Toxicity and management of overdose
•Naloxone
--(includes supporting the patient's airway as needed.)
-
•Interactions
•Additive: Alcohol, antihistamines, barbiturates, , , centrally acting
muscle relaxer (cyclobenzaprine) and other CNS depressants
Transdermal Fentanyl Patches Ans✓✓✓for opioid tolerant only
Patient-controlled analgesia (PCA) Ans✓✓✓-hospital setting
-
•Morphine and hydromorphone commonly used
•Only patient should push button
•Monitor respiratory status closely
-Continuous pulse oximetry is recommended
-•Monitors oxygen saturation (normal greater than 95% on room air)
Nursing Process and Opioid Analgesics Ans✓✓✓do not give opioid if
respiratory rate is less than 12.
- look at Urinary output
-Contraindications
,-Constipation
-•Administer before pain becomes severe
-
•Administer IV doses slowly- normally administering slowly over 5
minutes is recommended for morphine and hydromorphone.
-
pinpoint pupils can indicate morphine OD
•Monitor vs-RR <10(need to give naloxone),
-
•Use safety-side rails(x2; 4 raised side rails is considered a form of
restraint and should be avoided),
-
•Respiratory suppression may occur. The nurse should count the
respirations prior to administering
-
check the blood pressure prior to administering and withhold the dose if
the blood pressure is less than 100 systolic (notify the health care
provider
-
Avoid alcohol and other CNS depressants
Opioid Antagonist Ans✓✓✓•Reversal of opioid overdose effects
including:
•Respiratory depression, sedation, hypotension, respiratory distress
, •Naloxone (common) (has short duration) and naltrexone
-
•Elevated PTT, increased chance of bleeding
-
•Side effects
•Tremors, sweating, hypertension, tachycardia, dysrhythmias
0-
an cause seizures in patients who are opioid tolerant (chronic use of
opioids).
NON-opioid Analgesics Ans✓✓✓•Acetaminophen
•Mechanism of action:
inhibits prostaglandin synthesis decreasing pain impulses; also decreases
body temperature(antipyretic)
\
•Indications:
mild to moderate pain and fever
•Contraindications:
severe liver disease
=\•Side effects: normally well tolerated,
-\ but hepatotoxicity, nephrotoxicity, blood disorders (anemias)==
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
Analgesics Ans✓✓✓
Opioid Analgesics Ans✓✓✓There are 3 different classifications of
chemical structures for opioid analgesics.
1. morphine-like drugs;
2. meperidine-like drugs,
3. methadone-like drugs.
analgesics:
•Codeine, fentanyl, hydromorphone, meperidine, methadone, morphine,
oxycodone
-Fentanyl is 100x more potent than morphine and is dosed in mcg,
-Hydromorphone is 7x more potent than morphine
-pain and cough(codeine)
-
•Use caution: head injury, respiratory insufficiency, morbid obesity,
sleep apnea, pregnancy
-
•Side effects: Constipation, nausea, vomiting, sedation and mental
clouding, respiratory depression, dry mouth, urinary retention, pruritis,
dysphoria, euphoria, bradycardia, and hypotension
,Toxicity and management of overdose
•Naloxone
--(includes supporting the patient's airway as needed.)
-
•Interactions
•Additive: Alcohol, antihistamines, barbiturates, , , centrally acting
muscle relaxer (cyclobenzaprine) and other CNS depressants
Transdermal Fentanyl Patches Ans✓✓✓for opioid tolerant only
Patient-controlled analgesia (PCA) Ans✓✓✓-hospital setting
-
•Morphine and hydromorphone commonly used
•Only patient should push button
•Monitor respiratory status closely
-Continuous pulse oximetry is recommended
-•Monitors oxygen saturation (normal greater than 95% on room air)
Nursing Process and Opioid Analgesics Ans✓✓✓do not give opioid if
respiratory rate is less than 12.
- look at Urinary output
-Contraindications
,-Constipation
-•Administer before pain becomes severe
-
•Administer IV doses slowly- normally administering slowly over 5
minutes is recommended for morphine and hydromorphone.
-
pinpoint pupils can indicate morphine OD
•Monitor vs-RR <10(need to give naloxone),
-
•Use safety-side rails(x2; 4 raised side rails is considered a form of
restraint and should be avoided),
-
•Respiratory suppression may occur. The nurse should count the
respirations prior to administering
-
check the blood pressure prior to administering and withhold the dose if
the blood pressure is less than 100 systolic (notify the health care
provider
-
Avoid alcohol and other CNS depressants
Opioid Antagonist Ans✓✓✓•Reversal of opioid overdose effects
including:
•Respiratory depression, sedation, hypotension, respiratory distress
, •Naloxone (common) (has short duration) and naltrexone
-
•Elevated PTT, increased chance of bleeding
-
•Side effects
•Tremors, sweating, hypertension, tachycardia, dysrhythmias
0-
an cause seizures in patients who are opioid tolerant (chronic use of
opioids).
NON-opioid Analgesics Ans✓✓✓•Acetaminophen
•Mechanism of action:
inhibits prostaglandin synthesis decreasing pain impulses; also decreases
body temperature(antipyretic)
\
•Indications:
mild to moderate pain and fever
•Contraindications:
severe liver disease
=\•Side effects: normally well tolerated,
-\ but hepatotoxicity, nephrotoxicity, blood disorders (anemias)==
