Term
| What are opioids in combination (such as with APAP) used for? |
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Definition
|
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Term
| Opioids used as single agents are used for? |
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Definition
|
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Term
| Which opioids are classified as full opioid receptor agonists? |
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Definition
Codeine
Fentanyl
Hydrocodone
Hydromorphone
Methadone
Morphine
Oxymorphone |
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Term
| The primary receptor for pain relief is what? |
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Definition
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Term
| full agonists are used for acute and chronic pain and have no ____ effect. |
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Definition
Ceiling (meaning that the dose can go up)
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Term
| Should opioids at high doses be rotated? |
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Definition
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Term
| Long acting formulations of Morphine? |
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Definition
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Term
| Brand name of Morphine/Naltrexone |
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Definition
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Term
| What's special about Kadian? |
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Definition
can be opened and the beads put down a NGT for control over 24 hours, or can sprinkle on applesauce |
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Term
| What's special for Embeda? |
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Definition
If drug altered (for abuse) then naltrexone, an opioid blocker, is released. The capsules contents can be sprinkled on applesauce. Injection of crushed capsule contents can be fatal. |
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Term
|
Definition
Yes. Cross-reactivity with these agents (if allergy to 1 of the following, don't use another: morphine, codeine, hydrocodone, hydromorphone, oxycodone) |
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Term
| If one has a morphine - group allergy, what should be chosen? |
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Definition
| fentanyl, meperidine, methadone, tramadol |
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Term
| Symptoms of an opioid allergy? |
|
Definition
Difficulty breathing, severe drop in BP, serious rash, swellling of face, lips, tongue, larynx - use an agent in a different chemical class |
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Term
|
Definition
| constipation, nausea, vomitting |
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Term
| Opioids and constipation? |
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Definition
Tolerance usually develops to opioid side effects EXCEPT constipation |
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Term
| How to treat constipation associated with opioids? |
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Definition
Constipation will likely require stimulant laxatives (e.g. senna bisacodyl) or osmotic laxatives (e.g. MOM). Sometimes, docusate (DSS) alone may be enough, or in DSS + stiumlant lax. |
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Term
|
Definition
Methylnaltrexone (Relistor) is a laxative for constipation due to opioids (it blocks gut opioid - receptors).
The patient must have failed DSS + laxative (senna, bisacodyl). Administer SC every other day |
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Term
| Is respiratory depression associated with opioids? |
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Definition
YES! Respiratory depression caused by opioid overdose and can be fatal! |
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Term
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Definition
|
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Term
| How long should the fentanyl patch be left on? |
|
Definition
| change patch Q3 days (ocassionally change Q48) |
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Term
| If Fentanyl patche isn't dulling the pain, should they put on more patches? |
|
Definition
No. Do not increase dose if pain is controlled but doesn't last long enough. In this case you shorten the interval |
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|
Term
| What is fentanyl normally prescribed for? |
|
Definition
Chornic pain management only!
Not used PRN and not used as initial opioid agent |
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|
Term
| Does the Fentanyl patch work immediately? |
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Definition
Analgesic effect of patch can be seen 8-16 hours after application - do not stop other analgesic at first (decrease dose 50% for the first 12 hours)
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Term
Fentanyl: Do not apply > 1 patch each time and do not heat up patch or skin area before applying. Do not cover with healing pad. Caution with fever (tell patient to call doctor if they have a fever). Do not cover with heating pads. |
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Definition
| Statement. Not a question. |
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Term
| How should Fentanyl patches be discarded? |
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Definition
Dispose patch in toilet or cut it up and put it in coffee grounds. |
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Term
| Brand name for hydromorphone? |
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Definition
|
|
Term
| Brand name for Oxycodone? |
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Definition
|
|
Term
| Brand name for Oxycodone/APAP? |
|
Definition
Endocet, Percocet, Roxicet
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|
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Term
| Brand name for Oxymorphone? |
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Definition
|
|
Term
| Should Oxymorphone be taken on an empty stomach? |
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Definition
|
|
Term
| Brand name for Mehtadone? |
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Definition
|
|
Term
| Does Methadone have a liquid formulation? |
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Definition
|
|
Term
| Brand name for Meperidine? |
|
Definition
|
|
Term
| Merperidine short or long acting? |
|
Definition
SHORT duration of action (pain control for max 3 hours)
Obviously, do not use for chronic pain management
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Term
|
Definition
| Statement. Not a question. |
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Term
| Brand name for Hydrocodone + acetaminophen |
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Definition
|
|
Term
| Brand name for hydrocodone + acetaminophen |
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Definition
|
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Term
| Codeine used an antitusive is what schedule? |
|
Definition
|
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Term
|
Definition
| Statement. Not a question. |
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Term
|
Definition
|
|
Term
| Brand name for Tramadol + Acetaminophen? |
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Definition
|
|
Term
| Does tramadol affect seizure threshold? |
|
Definition
|
|
Term
|
Definition
| Statement. Not a question. |
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