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NR293 Final Exam Study Guide (Latest-2022)/ NR 293 Final Exam Study Guide/ NR293 Pharmacology Final Exam Study Guide / NR 293 Pharmacology Final Exam Study Guide: Chamberlain University |Latest and Updated Guide|

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NR293 Final Exam Study Guide (Latest-2022)/ NR 293 Final Exam Study Guide/ NR293 Pharmacology Final Exam Study Guide / NR 293 Pharmacology Final Exam Study Guide: Chamberlain University |Latest and Updated Guide| NR293 Pharm Final Exam Study Guide (Latest-2022)/ NR 293 Pharm Final Exam Study Guide...

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  • February 17, 2022
  • 46
  • 2021/2022
  • Exam (elaborations)
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,  Tissue injury causes the release of the following:

 BradykininHistaminePotassiumProstaglandinsSerotonin

 These substances stimulate nerve endings, starting the pain process.

 Rubbing a painful area with massage or liniment stimulates large sensory fibers

 Result

 Closes gate

 Reduces pain sensation

Adjuvant Drugs

 Assist primary drugs in relieving pain

 NSAIDs

 Antidepressants

 Anticonvulsants

 Corticosteroids

 Example: adjuvant drugs for neuropathic pain

 Amitriptyline (antidepressant)

 Gabapentin or pregabalin (anticonvulsants)

World health organization 3-Step Analgesic Ladder

 Step 1: non-opioids (with or without adjuvant medications) after the pain has been

identified and assessed. If pain persists or increases, treatment moves to

 Step 2: opioids with or without non-opioids and with or without adjuvants. If pain

persists or increases, management then rises to

 Step 3: opioids indicated for moderate to severe pain, administered with or without non-

opioids or adjuvant medications. (this should be the very last)




2

,Opioid Drugs

 Mild agonists: codeine, hydrocodone

 Strong agonists: morphine, hydromorphone, oxycodone, oxy-morphine, meperidine,

fentanyl, and methadone (watch out for addiction and resp. depression)

 Meperidine: not recommended for long-term use because of the accumulation of a

neurotoxic metabolite, normeperidine, which can cause seizures

Opioid Ceiling Effect(this is where the people ―addicted‖ like to live)

 Drug reaches a maximum analgesic effect

 Analgesia does not improve, even with higher doses

 Pentazocine

 Nalbuphine

Mechanism of Action

Agonists

 Bind to an opioid pain receptor in the brain

 Cause an analgesic response (reduction of pain sensation)

Agonists-Antagonists

 Bind to a pain receptor

 Cause a weaker neurologic response than a full agonist

 Also, called partial agonist or mixed agonist

Antagonists

 Reverse the effects of these drugs on pain receptors

 Bind to a pain receptor and exert no response

 Also, known as competitive antagonists




3

, Equianalgesia

 Hydromorphone (Dilaudid): seven times more potent than morphine (>7/10 pain scale)

Indications

 Opioids are also used for:

 Cough center suppression

 Treatment of diarrhea

 Balanced anesthesia

Contraindications

 Severe asthma

 Use with extreme caution in patients with:

 Respiratory insufficiency

 Elevated intracranial pressureCan be used to treat this condition as well

 Morbid obesity or sleep apnea

 Paralytic ileus

 Pregnancy

Adverse Effects

 CNS depression

 Leads to respiratory depression

 Most serious adverse effect

 Nausea and vomiting

 Urinary retentionDiaphoresis and flushingPupil constriction (miosis)

 ConstipationItching

Opioids Tolerance




4

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