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Any substance that produces stupor associated with analgesia and specifically refers to opioids
Narcotics
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Antagonist means
to block
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The main opioid drug to which all other pain management drugs are compared
morphine
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Why would agonist-antagonists be preferred over agonist?
Risk for abuse is less
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What is a common agonist-antagonist in offices?
Tramadol
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Narcotics treat what kind of pain
moderate to severe acute pain
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What are the actions of the narcotic agonist?
Slowed peristalsis, reduced cough reflex and hypotension
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What do agonist analgesics do?
Prevent painful feelings in the CNS
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What drug would be used for someone who has difficulty breathing caused by heart failure or fluid in the lungs?
Narcotic agonist analgesics
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Adverse reactions to narcotic analgesic drugs
bradycardia, hypotension, anorexia, confusion, dry mouth, euphoria, fainting, vomiting, pruritus, skin rash, skin itch, slow breathing, SOB
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What variables are watched most closely for signs of overdosage?
Sleepiness and respiratory rate
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AABCDEE
Ash about pain, assess pain, believe patient, choose pain control options, deliver interventions, empower patients enable them to control course
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When should narcotic agonists not be used
stomach or abdomen problem, increased pressure in eyes, head injury or loss of consciousness
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Geriatric considerations with opioids
should be placed on bowel regimen when opioids are started, propoxyphene and tramadol and methadone must be used with caution
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Once agonist is metabolized,
pt may feel more pain
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Cough reflex is reduced by these drugs, so
may be a problem in patients with lung disease
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Narcotics may produce a faster heart rate in patients with lung disease and a faster heart rate in people with a particular heart rhythm problem
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Oral narcotic agents take effect
in 15-20 minutes
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Opioids given PO are much less effective than those given by injection but they last longer than injection meds
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Narcotic agonists are metabolized by the
liver and leftovers through kidneys; 90% of drug is out within 24 hours
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When is taking agonist more effective?
Before the patient has severe pain
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Diet changes when taking agonists
increase fluid intake and fiber
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When taking the first doses,
pt should lie down for a short period to prevent nausea
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Each dose of Demerol should be taken
in one half glass of water because if not diluted, can exert a toxic anesthetic effect on mucous membranes
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Protect morphine from
light and freezing
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AA narcotics
act through the CNS, possibly through limbic system
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AAs
usually act like morphine in producing analesgia, euphoria, and respiratory and physical depression; may compete with other narcotics so may produce withdrawal symptoms in pts who are dependent on narcotics; less likely to be abused than pure narcotic agonists
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Other chemicals that work on pain centers
acetaminophen, aspirin, caffeine, barbiturate
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Percocet
oxy and acetaminophen
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Percodan
oxycodone and aspirin
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Vicoden
hydrocodone bitartrate and acetaminophen
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Empirin with codeine
aspirin and codeine
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Fiorinal with codeine
codeine, aspirin, caffeine, butalalital
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Tylox
oxycodone and acetaminophen
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Only AA in oral form
pentazocine
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Names of AAs
buprenex, stadol, nubain, talwin (pentazocine)
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Mild to moderate pain
propoxyphene, ethoheptazine, methotrimeprazine
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Excedrin
aspirin, acetaminophen, caffeine
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Methotrimeprazine
injection
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