NSG 511: Exam 2Questions and Correct Answers
Pure Opioid agonists (STRONG)
Morphine, Fentanyl, Hydromorphone, Meperidine, Methadone
Pure opioid agonists (MODERATE TO STRONG)
Codeine, Hydrocodone, Oxycodone
Tramadol (Ultram) MOA
nonopioid centrally acting analgesic; partial mu agonist, blocks reuptake of serotonin and NE,
activating spinal inhibition of pain
Pure opioid agonists MOA
agonize mu and kappa receptors, resulting in analgesia, sedation, respiratory depression,
euphoria, and decreased GI motility
narcotic vs opioid
umbrella term used for illegal and legal drugs vs. preferred name for legal drugs with
properties like morphine
Opioid indications
moderate to severe pain, cancer related pain, MI, dyspnea r/t CHF or pulmonary edema,
anxiety reduction (d/t sedation properties)
Kappa receptors
analgesia, sedation, decreased GI motility
Mu receptors
analgesia, respiratory depression, euphoria, sedation, physical dependence, decreased GI
motility
Delta receptors
responsive to endogenous opioid peptides, but not really to exogenous drugs
Acute pain
,resolves in 3-6 months or less when underlying cause (usually tissue damage) resolves
Chronic pain
>6 months
subcategory: cancer pain
Nociceptive pain
Caused by damage to body tissue; injury; achy, throbbing and responsive to opioids and non-
opioids
(includes somatic and visceral)
somatic pain
bones, muscles, joints (sharp and localized)
visceral pain
organ systems (aching and diffuse)
Neuropathic pain
caused by nerve pathology, described with sensory terms (i.e. shooting, tearing, burning),
responsive to adjuvants
Referred pain
pain that is felt in a location other than where the pain originates
breakthrough pain
abrupt, brief flare-up of moderate to severe pain despite well-controlled background pain;
common in advanced cancer patients
psychosomatic pain
manifestation of physical pain caused by underlying psychological factors
idiopathic pain
no known injury, disease or other cause of pain; very difficult to treat
PQRSTU
, P: Provocative or palliative
Q: Quality or quantity
R: Region or radiation
S: Severity scale
T: Timing
U: Understand patient's perception
FACES pain scale
for children (3+), mentally disabled, or language barrier
CPOT pain scale
for adults in critical condition
facial expression, body movement, muscle tension, compliance with ventilator/vocalization if
not intubated
Morphine routes
oral (slowest), IV (fastest), IM, subQ, rectal, epidural, intrathecal
Morphine adverse effects
Respiratory depression, Euphoria/Dysphoria, Constipation, Sedation, Orthostatic
hypotension, pruritis, emesis, neurotoxicity, miosis, increased ICP, cough suppression, biliary
colic, urinary retention, birth defects/newborn addiction
Morphine adverse effect: constipation
suppress peristalsis, contract anal sphincter; can cause fecal impaction, bowel perforation,
etc.
BUT highly effective in treating diarrhea
Morphine adverse effect: respiratory depression
largest reason for death in opioid use; can take anywhere from a few minutes to several hours
to occur
Pure Opioid agonists (STRONG)
Morphine, Fentanyl, Hydromorphone, Meperidine, Methadone
Pure opioid agonists (MODERATE TO STRONG)
Codeine, Hydrocodone, Oxycodone
Tramadol (Ultram) MOA
nonopioid centrally acting analgesic; partial mu agonist, blocks reuptake of serotonin and NE,
activating spinal inhibition of pain
Pure opioid agonists MOA
agonize mu and kappa receptors, resulting in analgesia, sedation, respiratory depression,
euphoria, and decreased GI motility
narcotic vs opioid
umbrella term used for illegal and legal drugs vs. preferred name for legal drugs with
properties like morphine
Opioid indications
moderate to severe pain, cancer related pain, MI, dyspnea r/t CHF or pulmonary edema,
anxiety reduction (d/t sedation properties)
Kappa receptors
analgesia, sedation, decreased GI motility
Mu receptors
analgesia, respiratory depression, euphoria, sedation, physical dependence, decreased GI
motility
Delta receptors
responsive to endogenous opioid peptides, but not really to exogenous drugs
Acute pain
,resolves in 3-6 months or less when underlying cause (usually tissue damage) resolves
Chronic pain
>6 months
subcategory: cancer pain
Nociceptive pain
Caused by damage to body tissue; injury; achy, throbbing and responsive to opioids and non-
opioids
(includes somatic and visceral)
somatic pain
bones, muscles, joints (sharp and localized)
visceral pain
organ systems (aching and diffuse)
Neuropathic pain
caused by nerve pathology, described with sensory terms (i.e. shooting, tearing, burning),
responsive to adjuvants
Referred pain
pain that is felt in a location other than where the pain originates
breakthrough pain
abrupt, brief flare-up of moderate to severe pain despite well-controlled background pain;
common in advanced cancer patients
psychosomatic pain
manifestation of physical pain caused by underlying psychological factors
idiopathic pain
no known injury, disease or other cause of pain; very difficult to treat
PQRSTU
, P: Provocative or palliative
Q: Quality or quantity
R: Region or radiation
S: Severity scale
T: Timing
U: Understand patient's perception
FACES pain scale
for children (3+), mentally disabled, or language barrier
CPOT pain scale
for adults in critical condition
facial expression, body movement, muscle tension, compliance with ventilator/vocalization if
not intubated
Morphine routes
oral (slowest), IV (fastest), IM, subQ, rectal, epidural, intrathecal
Morphine adverse effects
Respiratory depression, Euphoria/Dysphoria, Constipation, Sedation, Orthostatic
hypotension, pruritis, emesis, neurotoxicity, miosis, increased ICP, cough suppression, biliary
colic, urinary retention, birth defects/newborn addiction
Morphine adverse effect: constipation
suppress peristalsis, contract anal sphincter; can cause fecal impaction, bowel perforation,
etc.
BUT highly effective in treating diarrhea
Morphine adverse effect: respiratory depression
largest reason for death in opioid use; can take anywhere from a few minutes to several hours
to occur
