Opioids

Chapter 10: analgesic medstypes of pain•acute pain: short duration of pain•Chronic pain: long term pain, vital signs won't show pain level like acute•somatic pain: from ligaments, joints, and skeletal muscle•Superficial pain: from the skin•phantom pain: from a body part that is removed. •Neuropathic pain: pain from a disturbance of a nerve•referred pain: pain is away from the area of origin•Cancer pain: pain related to cancerOpioids: -one and -sone•moderate to severe pain management•Causes constipation so increase fluid and fiber intake•not for long term pain management because they are highly addictive except fentanyl patches that are for chronic pain•have the patient understand that the medication causes hypotension so SLOW position changes•Patients will think itchiness means an allergic reaction but that is a pharmacologic response, most patients who reported nausea were allergic•No antipyretic effects (not fever reducing) or anti-inflammatory effect so don't give to patients with your or rheumatoid arthritis morphine sulfate•severe pain management•Highly addictive and abusive potential•not for patients with renal problemsFentanyl•comes in transdermal patches for chronic pain•For severe pain management•good for patients who can not take oral pain medicationmethadone•for detoxification of opioid addicts•Absorbed through the gi tract and eliminated through the liver so safer for patients with renal issues who can not take morphine•may cause cardiac dysrhythmia Oxycodone•commonly given with acetaminophen (Tylenol) and aspirin•structurally related to morphine so comparable activityantidote: naloxoneNarcan mnemonics for opioidsF,f,f,ffluidsfruitfiberFill the toiletAIMSA: assess ABCI: intervention: oxygenM: make HCP awareS: second dose of naloxoneGreatest risk: age of 70COPD, Asthma, allergy, RR below 12 Dependence vs tolerancedependence is when a patient's body will show withdrawals. The patient will have to discontinue the medication. There is a physical dependence and a psychological dependence. Physical can occur from stopping a drug abruptly and physiological is when the patient wants the drug for reasons outside of pain relief. Tolerance is from repetitive use of a drug resulting in needing a increased dosage. Tolerance will nt have withdrawn symptoms.non-opioidsAcetaminophen Tylenol •substitute for aspirin •mild to moderate pain•Fewer drug interactions•Antipyretic effect•choice for children and infants with the flu/fever•:( possible liver disease for dosages over 3,000 or 2,000 for elderly•AE: nausea, vomiting, hepatotoxicity, nephrotoxicity•Antidote: acetylcysteineTramadol •moderate to severe pain•Rapidly absorbed•Absorption is unaffected by food•AE: drowsiness, dizziness, headache, nausea, constipation, respiratory depression•Seizures reported in patients taking both normal and excessive dosage•Contraindication in patients who take antidepressantsLidocaine (transdermal)•a topical anesthetic•Local pain relief•Skin may develop redness or edema•Can be used with antidepressants Acute pain: myocardial infarction, dental procedures, surgical procedures, kidney stonesMorphine common for the surgical procedureschronic pain: arthritis, cancer, lower back painTransdermal patch for lower back pain, Tylenol for the arthritis for the anti-inflammatory effects