Opiods

Question 1

What are the generic and brand names of opioids?

Answer 1

• Codeine
• Morphine (MST, Zomorph)
• Oxycodone (Shortec, Longtec, OxyContin, OxyNorm)

Question 2

What is the method of action of opioids?

Answer 2

• Activation of the G protein coupled opioid μ receptor in the CNS
• = ↓ neural excitability
• = ↓ pain transmission
• = blunt the response to hypoxia/hypercapnoea in the medulla
• = ↓ sympathetic nervous system

Question 3

What are the indications for opioids?

Answer 3

• Rapid relief of acute pain
• Post op pain
• Pain after an MI
• Relief of chronic pain when lower levels of the analgesic ladder don’t work
• To relieve breathlessness in end of life care
• To relieve breathlessness and anxiety in acute pulmonary oedema

Question 4

What are the contraindications of opioids?

Answer 4

• Hepatic failure – dose reduction
• Renal impairment – dose reduction
• Elderly – dose reduction
• Respiratory failure – unless palliative care
• Biliary colic

Question 5

What are the side effects of opioids?

Answer 5

• Respiratory depression
• Euphoria
• Neurological depression
• Nausea/vomiting
• Pupillary constriction
• Constipation
• Itching
• Urticaria
• Vasodilation
• Sweating
• Tolerance and dependence = withdrawal reaction

Question 6

What drugs interact with opioids?

Answer 6

• Antipsychotics – also a sedating drug
• Benzodiazepines – also a sedating drug
• Tricyclic antidepressants – also a sedating drug

Question 7

What organ eliminates opioids?

Answer 7

Kidney

Question 8

What information should be given to a patient taking opioids?

Answer 8

• May need to prescribe a laxative and antiemetic alongside

* Do not drive or operate heavy machinery if feeling drowsy