Opioid Analgesic Drug Effect – Pharmacology

Opioid Analgesic Drug Effect – Pharmacology

This chapter of pharmacology is about different types of drug and also discuss Opioid analgesic drug effect .


Examples of Opioids

Hydromorphone, fentanyl, morphine sulfate, naloxone hydrochloride, methadone hydrochloride.


Morphine, hydromorphone, oxycodone Indications:

Moderate/severe pain
Post-op pain


Fentanyl, sufentanil, alfentanil Indications:

Balance sedation during surgery


drug tolerance

the tendency for larger doses of a drug to be required over time to achieve the same effect


Somatic Pain

Pain that originates from skeletal muscles, ligaments, or joints.


Visceral Pain

Pain that originates from organs or smooth muscles


Superficial Pain

Originates from the skin and mucous membranes


Deep pain

occurs in tissues below skin level


Vascular pain

Believed to originate from the vascular or perivascular tissues and is thought to account for a large percentage of migraine headaches


Referred Pain

When visceral nerve fibers synapse at a level in the spinal cord close to fibers that supply specific subcutaneous tissues in the body.


Neuropathic Pain

Results form damage to peripheral or CNS nerve fibers by disease or injury but may also be idiopathic (unexplained)


Phantom Pain

Occurs in an area of the body that has been removed.


Cancer Pain

Can be acute or chronic or both.
Most often results from pressure of the tumor mass against nerves, organs, or tissues.


A patient’s emotional response to pain is molded by

Age, sex, culture, previous pain experience, and anxiety level.


drug tolerance A patient’s emotional response to pain is molded by

Age, sex, culture, previous pain experience, and anxiety level.

A patient’s emotional response to pain is molded by

Age, sex, culture, previous pain experience, and anxiety level.


Central Pain

Occurs with tumors, trauma, inflammation, or disease affecting CNS tissues.


Patient-controlled analgesia (PCA)

Drug delivery system that allows patients to self-administer analgesic medications on demand.


PCA by proxy

Family/friends controlling the PCA pump


Opioid tolerance

state of adaptation in which exposure to a drug causes changes in drug receptors that result in reduced drug effects over time


Breakthrough Pain

Pain that occurs between long-term doses of pain medication


When should you use Opioids?

For visceral and superficial pain; after surgery.


When should you use non-opioids?

Somatic pain and injuries with inflammation


Examples of mild opioids

Codeine and hydrocodone


Examples of strong opioids

Morphine, hydromorphone, levorphanol, oxycodone, oxymorphone, meperidine, fentanyl, and methadone


Acetaminophen Mechanism of action

Inhibits prostaglandin synthesis in CNS
Lowers fever by acting on the hypothalamus


Acetaminophen Indications (why give it?)

Pain and fever


Acetaminophen Contraindications (why not give it?)

Allergy
Severe liver disease
G6PD deficiency


Acetaminophen AE and SE

AE: anemia, nephrotoxicity, hepatotoxicity
SE: N/V and rash


Acetaminophen Interactions

alcohol, warfarin, phenytoin, barbiturates


Acetaminophen Assessment

Allergy, potential interactions, CNS depression, alcohol/substance use, pain assessment


What is the antidote for Acetaminophen overdose?

acetylcysteine


Fentanyl, sufentanil, alfentanil Indications:

Balance sedation during surgery


Codeine, hydrocodone Indications:

Cough suppressant


Opioid Adverse Effects

AE: CNS/respiratory depression, sedation, abuse, urinary retention, dec BP

SE: N/V/D, itching, dry mouth


Opioid Assessment

VS
age
allergy
resp function
head injury
neuro status/LOC
neuro disorders
GI/GU functioning


Opioid Contraindications

Known drug allergy
Severe asthma
Caution: resp insufficiency, elevated ICP, obesity/sleep apnea, Myasthenia Gravis, pregnancy


Opioid Interactions

Alcohol
Antihistamines
Barbiturates
Benzodiazepines
Monoamine oxidase inhibitors


drug tolerance

the tendency for larger doses of a drug to be required over time to achieve the same effect


Somatic Pain

Pain that originates from skeletal muscles, ligaments, or joints.


Visceral Pain

Pain that originates from organs or smooth muscles


Superficial Pain

Originates from the skin and mucous membranes


Deep pain

occurs in tissues below skin level


Vascular pain

Believed to originate from the vascular or perivascular tissues and is thought to account for a large percentage of migraine headaches


Referred Pain

When visceral nerve fibers synapse at a level in the spinal cord close to fibers that supply specific subcutaneous tissues in the body.


Neuropathic Pain

Results form damage to peripheral or CNS nerve fibers by disease or injury but may also be idiopathic (unexplained)


Phantom Pain

Occurs in an area of the body that has been removed.


Cancer Pain

Can be acute or chronic or both.
Most often results from pressure of the tumor mass against nerves, organs, or tissues.


Central Pain

Occurs with tumors, trauma, inflammation, or disease affecting CNS tissues.


Patient-controlled analgesia (PCA)

Drug delivery system that allows patients to self-administer analgesic medications on demand.


PCA by proxy

Family/friends controlling the PCA pump


Opioid tolerance

state of adaptation in which exposure to a drug causes changes in drug receptors that result in reduced drug effects over time


Breakthrough Pain

Pain that occurs between long-term doses of pain medication


When should you use Opioids?

For visceral and superficial pain; after surgery.


When should you use non-opioids?

Somatic pain and injuries with inflammation


Examples of mild opioids

Codeine and hydrocodone


Examples of strong opioids

Morphine, hydromorphone, levorphanol, oxycodone, oxymorphone, meperidine, fentanyl, and methadone


Acetaminophen Mechanism of action

Inhibits prostaglandin synthesis in CNS
Lowers fever by acting on the hypothalamus


Acetaminophen Indications (why give it?)

Pain and fever


Acetaminophen Contraindications (why not give it?)

Allergy
Severe liver disease
G6PD deficiency


Acetaminophen AE and SE

AE: anemia, nephrotoxicity, hepatotoxicity
SE: N/V and rash


Acetaminophen Interactions

alcohol, warfarin, phenytoin, barbiturates


Acetaminophen Assessment

Allergy, potential interactions, CNS depression, alcohol/substance use, pain assessment


What is the antidote for Acetaminophen overdose?

acetylcysteine


Examples of Opioids

Hydromorphone, fentanyl, morphine sulfate, naloxone hydrochloride, methadone hydrochloride.


Morphine, hydromorphone, oxycodone Indications:

Moderate/severe pain
Post-op pain


Codeine, hydrocodone Indications:

Cough suppressant


Opioid Adverse Effects

AE: CNS/respiratory depression, sedation, abuse, urinary retention, dec BP

SE: N/V/D, itching, dry mouth


Opioid Assessment

VS
age
allergy
resp function
head injury
neuro status/LOC
neuro disorders
GI/GU functioning


Opioid Contraindications

Known drug allergy
Severe asthma
Caution: resp insufficiency, elevated ICP, obesity/sleep apnea, Myasthenia Gravis, pregnancy


Opioid Interactions

Alcohol
Antihistamines
Barbiturates
Benzodiazepines
Monoamine oxidase inhibitors


the tendency for larger doses of a drug to be required over time to achieve the same effect


Somatic Pain

Pain that originates from skeletal muscles, ligaments, or joints.


Visceral Pain

Pain that originates from organs or smooth muscles


Superficial Pain

Originates from the skin and mucous membranes


Deep pain

occurs in tissues below skin level


Vascular pain

Believed to originate from the vascular or perivascular tissues and is thought to account for a large percentage of migraine headaches


Referred Pain

When visceral nerve fibers synapse at a level in the spinal cord close to fibers that supply specific subcutaneous tissues in the body.


Neuropathic Pain

Results form damage to peripheral or CNS nerve fibers by disease or injury but may also be idiopathic (unexplained)


Phantom Pain

Occurs in an area of the body that has been removed.


Cancer Pain

Can be acute or chronic or both.
Most often results from pressure of the tumor mass against nerves, organs, or tissues.


Central Pain

Occurs with tumors, trauma, inflammation, or disease affecting CNS tissues.


Patient-controlled analgesia (PCA)

Drug delivery system that allows patients to self-administer analgesic medications on demand.


PCA by proxy

Family/friends controlling the PCA pump


Opioid tolerance

state of adaptation in which exposure to a drug causes changes in drug receptors that result in reduced drug effects over time


Breakthrough Pain

Pain that occurs between long-term doses of pain medication


When should you use Opioids?

For visceral and superficial pain; after surgery.


When should you use non-opioids?

Somatic pain and injuries with inflammation


Examples of mild opioids

Codeine and hydrocodone


Examples of strong opioids

Morphine, hydromorphone, levorphanol, oxycodone, oxymorphone, meperidine, fentanyl, and methadone


Acetaminophen Mechanism of action

Inhibits prostaglandin synthesis in CNS
Lowers fever by acting on the hypothalamus


Acetaminophen Indications (why give it?)

Pain and fever


Acetaminophen Contraindications (why not give it?)

Allergy
Severe liver disease
G6PD deficiency


Acetaminophen AE and SE

AE: anemia, nephrotoxicity, hepatotoxicity
SE: N/V and rash


Acetaminophen Interactions

alcohol, warfarin, phenytoin, barbiturates


Acetaminophen Assessment

Allergy, potential interactions, CNS depression, alcohol/substance use, pain assessment


What is the antidote for Acetaminophen overdose?

acetylcysteine


Examples of Opioids

Hydromorphone, fentanyl, morphine sulfate, naloxone hydrochloride, methadone hydrochloride.


Morphine, hydromorphone, oxycodone Indications:

Moderate/severe pain
Post-op pain


Fentanyl, sufentanil, alfentanil Indications:

Balance sedation during surgery


Codeine, hydrocodone Indications:

Cough suppressant


Opioid Adverse Effects

AE: CNS/respiratory depression, sedation, abuse, urinary retention, dec BP

SE: N/V/D, itching, dry mouth


Opioid Assessment

VS
age
allergy
resp function
head injury
neuro status/LOC
neuro disorders
GI/GU functioning


Opioid Contraindications

Known drug allergy
Severe asthma
Caution: resp insufficiency, elevated ICP, obesity/sleep apnea, Myasthenia Gravis, pregnancy


Opioid Interactions

Alcohol
Antihistamines
Barbiturates
Benzodiazepines
Monoamine oxidase inhibitors


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