NU 578 - Unit 2 Study Guide with Complete Solutions

NU 578 - Unit 2 Study Guide with Complete Solutions Opioids Drugs - Answer-Drugs: Opioids - MOA - Answer-- Bind to "opiate receptors" in the brain, which disrupts the transmission of pain signals in the CNS. - Mimic actions of endogenous opiates (endorphins, enkephalins, dynorphins). - Primarily activate mu receptors, but also activate Kappa Opioids - Effect - Answer-* Relieve pain & induce euphoria Also cause sedation, respiratory depression, miosis, constipation, nausea, & suppress the cough reflex. Opioids - Uses - Answer-- Pain relief - Cough suppression EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 2/37 - Relief of dyspnea - Preoperative sedation Opioids - Side Effects - Answer-Hypotension sedation nausea itching miosis muscle weakness constipation Urinary Retention Biliary Colic Increased ICP Treatment of Opioid- Induced Constipation - Answer-methylnaltrexone (Relistor) naloxegol (Movantik) Blocks opioid receptors in the GI tract EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 3/37 * Does not cross blood-brain barrier, so does not reverse analgesia Opioids - Drug Interactions - Answer-CNS depressants! Anticholinergics Drugs that lower BP Opioids - Contraindications/Warnings - Answer-Decreased respiratory reserve Labor and delivery Inflammatory Bowel disease Head Injury Opioids - Patient Educaiton - Answer- Opioid toxicity - Answer-3 signs: - coma - pinpoint pupils - respiratory depression - may be fatal! Tolerance - Answer-a state in which a drug user needs larger amounts of the drug to produce the same effect on the body EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 4/37 Physical Dependence - Answer-A state in which an abstinence syndrome will occur if drug use is abruptly stopped Abuse - Answer-drug use that is inconsistent with medical or social norms Addiction - Answer-disease characterized by and individual pathologically pursuing rewards and relief by substance use and other behaviors Full opioid agonists - Answer-- Good for severe pain - May give a feeling of euphoria Example: Morphin, codeine, hydromorphone Partial opioid agonists (Agonist-antagonist) - Answer-- Good for moderate pain - May act as antagonists at some receptors and precipitate withdrawal. Example: pentazocine, Suboxone, buprenorphine, nalbuphine Partial opioid agonists (Agonist-antagonist) Drugs: - Answer-Pentazocine Suboxone Buprenorphine EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER, 2024 Page 5/37 Nalbuphine Partial opioid agonists (Agonist-antagonist) Action - Answer-Acts as antagonists at mu receptors, and agonists at kappa receptors Buprenorphine (Suboxone) Action: - Answer-Acts as a partial agonist at mu receptors, and an antagonist at kappa receptors Medications for those with hx of Opioid abuse - Answer-morphine/naltrexone (Embeda) Opioid antagonists - Answer-Reverse all narcotic effects including pain relief, euphoria, and respiratory depression. Naloxone (Narcan) Action: - Answer-Competes for opioid re