Summary Nr 293 Pharm Exam 2 Study Guide

NR 293 PHARM EXAM 2 STUDY GUIDE NR 293 Pharmacology for Nursing ATI Chapters: 7-13, 15-18, 20 Chapter 10: Analgesics Opioids -used for moderate to severe pain -bind to opioid receptors in the CNS -side effects are usually resp. depression, sedation, constipation, GI upset, hypotension & urinary retention Opioid Agonists **morphine (ex. Fentanyl, Codeine, Oxycodone) Indications: moderate to severe pain, promote sedation Mode of Action: binds to opioid receptors in the CNS Adverse/Side Effects: -respiratory depressions -sedation -constipation -hypotension -urinary retention -cough suppression -GI upset -biliary colic -OD -pupil constriction Nursing Inter./Pt Ed.: Naloxone Narcan Is Antidote; monitor VS, pain level; stop opioids if pt RR is 12; admin. slowly & around the clock for cancer pain;  fiber/fluids; administer laxative or stool softener; monitor I/O; auscultate for lung crackling; instruct pt to avoid driving/operating machinery; AVOID giving to pt w/ history of biliary colic (use meperidine); avoid alcohol Contradictions/Precautions: opioid tolerance; contradicted after biliary tract surgery; pre-mi infants during/after delivery; respiratory insufficiency; pregnancy; inflam. bowl disease [ex. paralytic ileus] Interactions: -CNS depressants [ex. barbiturates, benzodiazepines] -monoamine oxidase inhibitors (MAOIs) can cause seizures, coma, etc. -anticholinergic agents hydromorphone (Dilaudid) very potent Indications: moderate to severe pain Mode of Action: opiate receptors bind to CNS Adverse/Side Effects: -seizures -tolerance -sedation -resp. depression -constipation -GI upset Nursing Inter./Pt Ed.: may cause drowsiness, avoid alcohol; use pain scale; Naloxone (Narcan) is anecdote; discontinue gradually; for direct IV admin dilute & admin over 5 min Opioid Antagonist Naloxone (Narcan) Indications: opioid overdose; reversal of opioid effects Mode of Action: blocks opioid receptors in the CNS