1
Q
Therapeutic Classification
A
narcotic analgesic
2
Q
Pharmacologic Classification
A
opioid agonist
3
Q
Mechanism of Action
A
Occupies mu and kappa receptor sites in brain and dorsal horn of the spinal cord that alter release of afferent neurotransmitters.
- Alters perception of and emotional response to pain
- Produces analgesia and euphoria
- Mimics actions of endogenous endorphins
4
Q
Indications
A
- Acute & severe chronic pain
- Relieving acute MI
5
Q
Contraindications
A
- Hypersensitivity
- Premature infants (b/c blood-brain barrier permeability → increase CNS effect)
6
Q
Precautions
A
- Elderly
- Undiagnosed abdominal pain
- Hepatic/renal impairment
- Shock (don’t want to drop BP)
- CNS depression
- Head injury/increased ICP
- COPD
7
Q
Effect of drug interaction with a CNS depressant?
A
Increased sedation.
8
Q
Effect of drug interaction with an opioid antagonist?
A
Reversed effect.
9
Q
Effect of drug interaction with an antidiarrheal?
A
Additive constipation.
10
Q
pregnancy category?
A
Pregnancy Category C
11
Q
Adverse Effects
A
- CNS depression
- Respiratory depression
- Constipation, nausea, vomiting
- Urinary retention
- Sedation, dizziness, anxiety, disorientation
- Orthostatic hypotension
- Pruritus with IV or epidural route
12
Q
Nursing Considerations
A
- Complete assessment, including pain scale (before & after)
- Assess respiratory function
- Monitor vital signs
- Monitor for respiratory depression, HTN, CNS effects
- Prevent constipation, monitor I&O
- Evaluate effectiveness
Unit II Nursing 160
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