Narcotic Analgesics and Anesthesia Drugs

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