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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker
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Chapter 26: Opioid Agonists, Opioid Antagonists, and Antimigraine Agents

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Karch’s Focus on Nursing Pharmacology, 9th Ed., Tucker | Registered Nurse (RN) School Study Aid

Chapter 26: Opioid Agonists, Opioid Antagonists, and Antimigraine Agents
15 Picmonics to Learn | 27 mins
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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2 mins
Buprenorphine-Naloxone (Suboxone)
Mechanism of Action
Combination Drug
Partial Opioid Receptor Agonist (Buprenorphine)
Opioid Receptor Antagonist (Naloxone)
Indication
Opioid Use Disorder
Side Effects
CNS Depression
Diaphoresis
Hypotension
Considerations
Low Abuse Potential
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2 mins
Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)
Abuse Assessment
Euphoria
Miosis
CNS Depression
Abuse Withdrawal
Yawning
Gooseflesh
Sweating
Rhinorrhea
Kicking Movements
Consideration
Naloxone
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1 min
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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1 min
Opioid Antidote
Antidote
Naloxone
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29 secs
Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)
Mechanism
Smooth Muscle Contraction
Vasoconstriction
Indications
Migraine
Postpartum Hemorrhage
Side Effects
Nausea and Vomiting
Severe Hypertension
Tachycardia
Considerations
2nd Line Agent
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2 mins
Sumatriptan
Mechanism of Action
Short Half-Life
5-HT Agonist
Inhibits Trigeminal Nerve Activation
Induces Vasoconstriction
Indications
Migraine
Cluster Headache
Side Effects
Increased Risk of Serotonin Syndrome
Paresthesias
Coronary Vasospasm
Contraindication
Prinzmetal's Angina
Coronary Artery Disease (CAD)
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3 mins
Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
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48 secs
Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
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2 mins
Opioids Overview
Indications
Pain
Weaning
Cough
Diarrhea
Mechanism of Action
Agonists at Mu (μ), Kappa (Κ), and Delta (δ) Receptors
Decrease Synaptic Transmission
Side Effects
Respiratory Depression
Addiction
Miosis
Constipation
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2 mins
Pain Assessment
Types of Pain
Acute Pain
Chronic Pain
OPQRST Mnemonic
Onset
Provoking or Palliative
Quality
Radiation
Severity
Timing
Nursing Considerations
Subjective Findings
Objective Findings
Reassessment of Pain
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2 mins
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
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2 mins
Oxycodone
Mechanism of Action
Opioid Receptor Agonist
Indication
Refractory Pain
Side Effects
Respiratory Depression
Constipation
CNS Depression
Considerations
Addiction
Naloxone
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2 mins
Fentanyl
Mechanism of Action
Opioid Receptor Agonist
High Potency
Indications
Anesthesia Induction
Chronic Pain
Breakthrough Pain
Side Effects
CNS Depression
Respiratory Depression
Constipation
Miosis
Considerations
Addiction
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3 mins
Acetaminophen-Hydrocodone (Vicodin)
Mechanism of Action
Combination Analgesic
Opioid Receptor Agonist
Hydrocodone
Reversible Inhibition of COX
Acetaminophen
Indication
Moderate to Severe Pain
Side Effects
CNS Depression
Respiratory Depression
Hepatotoxicity
Considerations
Addiction
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2 mins

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