NSG 511 PHARM EXAM 2 Q AND A

ISM:gkFinitegkM Chaptergk12:gkDifferencegkEquationsgkandgkMathematicalgkM
ath odels
NSG 511 PHARM EXAM 2 Q AND A
Morphine-njdrugnjclassnj-njanswer--drugnjclass:njopioidnjagonist

Morphine-njindicationnjfornjusenj-njanswer--indicationnjofnjuse:
-Moderatenjtonjseverenjpainnj(typicallynjseverenjpain)
-Cancernjrelatednjpain
-
Myocardialnjinfarctionnjrelatednjpainnj(helpsnjtonjdecreasenjpreloadnjwhichnjdecreasednjO2njdemandnjwhich
ecreasesnjanxiety)
-DyspneanjrelatednjtonjCHFnjornjpulmonarynjedema
-Preoperativenjsedationnjandnjanxietynjreductionnj("twilight"njsleep)

Morphine-njMOAnj-njanswer--MOA:
-MunjandnjKappanjagonist
-
AgonistnjatnjmunjandnjkappanjreceptorsnjinnjCNSnjtonjproducenjalterednjpainnjperceptionnjandnjCNSnjdepress
n

Morphine-njbeneficialnjeffectsnj-njanswer--beneficialnjeffects:
-analgesianj(painnjrelief)
-sedation
-euphoria

Morphine-njsidenjeffectsnj-njanswer--sidenjeffects:
-Respiratorynjdepression
-Constipationnj(increasednjoverallnjpainnjseveritynjduenjtonjincreasednjvisceralnjpain)
-Orthostaticnjhypotension
-Urinarynjretention
-Coughnjsuppression
-Biliarynjcolic
-Emesis
-ElevationnjofnjICPnj(respiratorynjdistressànjincreasednjCO2njànjincreasednjpressurenjinnjthenjbrain
-Euphoria/dysphoria
-Sedation
-Miosis
-Neurotoxicity
-Birthnjdefectsnjandnjnewbornnjwithdrawal

Morphine-njdrugnjinteractionsnj-njanswer--drugnjinteractions:
-1stnjpassnjeffectnjfornjoralnjdoses
-Withdrawal
-Tolerance:njdevelopsnjfornjanalgesia,njsedation,njeuphoria,njandnjrespiratorynjdepression
-Physicalnjdependence:njafternj20njdaysnjofnjhighnjdoses
-Highnjabusenjandnjaddictionnjpotential
-
Abstinencenjsyndromenjdevelopsnjifnjdrugnjacutelynjd/
cnj(yawning,njrhinorrhea,njdiaphoresisnj~10Hnjafternjlastnjdose,njirritability,njtremor,njgoosebumps/
flesh,njweakness,njN/

, V,njChapter
cramping, njkicking)
gk12: njcan
gkDifference njavoidnjgk
gkEquations via njtapering
and njofnjthe
gkMathematical gkM njdrugnjovernj3njdaysnj(therapeutic users)
ISM:gknjFinite njandnj7-
gkM
odels
10njdaysnj(abusenjsituations) ath
-Polypharmacynj(tablenj28-4):njwatchnjBPnjmedications,njsedation,njconstipation,njurinarynjretention

Morphine-njnursingnjimplicationsnj-njanswer--nursingnjimplications:
-Routes:njoral,njIM,njIV,njSQ,njepidural,njandnjintrathecalnj(intonjthenjCSFnjvianjspinenjornjsubarachnoidnjspac
-
Specialnjoralnjformulations:njCRnj(controllednjrelease),njER,njIRnj(ERnjandnjCRnj=njextendednjduration)nj(IRnj
goodnjwhennjtherenjisnjnonjIV/centralnjlinenjaccess)
-Metabolizednjinnjlivernjandnjexcretednjinnjurine
-Onsetnjofnjaction:njslowestnjfornjoralnjroutenj(30-60njmins),njparenteralnjroutenj(10-15njmins)
-Duration:nj4-5njhoursnjfornjmostnjroutes;njepidural,njintrathecal,njandnjtransdermalnjarenjextendednjduration
-Poornjlipidnjsolubility/bloodnjbrainnjbarriernj(can'tnjpassnjthroughnjeasily):njneednjtonjbenjcarefulnjwithnjbabies
infantsnj(respiratorynjdepression,njwithdrawal)njandnjoldernjadultsnj(lowernjdoses)
-Breathing!nj(respiratorynjrate/rhythm/quality)
-
Hypotensionnj(positionnjchanges,njtakenjtimenjwithnjmovement,njnauseanjoccursnjwithnjpositionnjchangesnja
well)
-Sedation/neurologicalnjeffects
-Safety
-Bowelnjprogramnj(schedulednjsoftener,njPRNnjsuppository/enema,njwalking/movement,njincreasenjfluids/
fiber)
-Timingnjandnjbreakthroughnj(rescue)njdoses

Pentazocine-njdrugnjclassnj-njanswer--drugnjclass:njopioidnjagonist-antagonist

Pentazocine-njindicationnjfornjusenj-njanswer--indicationnjfornjuse:njmildnjtonjmoderatenjpain

Pentazocine-njMOAnj-njanswer--MOA:njagonizesnjkappanjandnjantagonizesnjmunjreceptors

Pentazocine-njbeneficialnjeffectsnj-njanswer--beneficialnjeffects:njanalgesianj(painnjrelief)

Pentazocine-njsidenjeffectsnj-njanswer--sidenjeffects:njdecreasednjsedation/
euphorianj(comparednjtonjmorphine)

Pentazocine-njdrugnjinteractionsnj-njanswer--drugnjinteractions:
-notnjinterchangeablenjwithnjanjpurenjopioidnjagonist
-lownjabusenjpotential

Pentazocine-njnursingnjimplicationsnj-njanswer--nursingnjimplications:
-Othernjmedicationsnj(specificallynjpurenjopioids)

Naloxonenj(Narcan)-njdrugnjclassnj-njanswer--drugnjclass:njopioidnjantagonist

Naloxonenj(Narcan)-njindicationnjfornjusenj-njanswer--indicationnjfornjuse:njreversalnjagent/
antidotenjfornjopioidnjOD

Naloxonenj(Narcan)-njMOAnj-njanswer--MOA:njcompetitivenjantagonistnjofnjmunjandnjkappanjreceptors

Naloxonenj(Narcan)-njbeneficialnjeffectsnj-njanswer--beneficialnjeffects:njreversingnjrespiratorynjdepression

Naloxonenj(Narcan)-njsidenjeffectsnj-njanswer--sidenjeffects:njwithdrawalnjsymptomsnjifnjgivennjtoonjmuch/fa