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Narcotic Analgesics and Anesthesia Drugs
Narcotic Analgesics
Opioids
Actions–Analgesia
– Euphoria
– Sedation
Opioids
Primary Use–Moderate Pain
– Severe Pain
–Acute Pain
–Chronic Pain
– Breakthrough Pain
Opioids
Other Uses
– Pre-Op Sedation
–Adjunct Anesthesia
–Anti Anxiety
–Diarrhea
–Opiate Dependence
Opioids
Common Opioids
– Morphine sulfate– Codeine– meperidine HCl (Demerol)– hydromorphone (Dilaudid)– fentanyl (Duragesic)– oxycodone (OxyContin)
Opioids
Common Routes
– IV– IM– Subcutaneous– Oral– Transdermal– Epidural
Opioids
Adverse Reactions
Euphoria, dysphoria, confusion, sedation
Nausea, vomiting, constipation
Hypotension, bradycardia or tachycardia
Urinary hesitancy, dysuria
Respiratory depression, cough depression
Allergic reactions, pruritis Pain, irritation at injection site
Opioids
Contraindications
Opiate allergies
Head injuries, increased intracranial pressure
Convulsions
Ulcerative colitis
Pulmonary diseases (asthma, COPD)
Renal or hepatic dysfunction
Opioids
Not recommended during labor
Use caution with elderly
Not recommended for biliary surgery
Not recommended during lactation
Precautions
Opioids
Opioid Naive
Tolerance Addiction
Precautions
Opioids
Precautions
Opioids and Acetaminophen
Daily acetaminophen intake should NOT EXCEED 4 grams
Opioids
Interactions
CNS Depressants
Use caution whenever two or more CNS depressants given
Opioids
Special Circumstances
Opiates of Choice
CodeinePersistent Cough
MorphineMyocardial Infarct
MeperidineBiliary Surgery
Opioids
Opiate Poisoning
miosis
Respirations < 10 / min
hypoxia
Opioids
Opiate Antagonist
Opioids
Patient Controlled Analgesia (PCA)
Opioids
Epidural
Opioids
Transdermal
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