Quiz 19: Opioid Narcotic Analgesics

Nursing

Opioid analgesics are chemically related to opium or morphine and are used as a pain reliever. All opioid analgesics relieve moderate to severe pain in nearly all kind of a pain in the body. Pain associated with bone marrow autopsy, pain due to trauma or cancer and visceral pain is treated with opioid analgesics. Moderate to severe pains are often associated with post-trauma injury, cancer, and myocardial infarction. Virtually, opioid analgesics are known to treat all kind of pains.

Opioid analgesics are schedule drugs and are prescribed very carefully as these drugs may have contraindication with other drugs. Such contraindications may result in negative effects on the cardiac health of the patient. Metaprel has a side effect of headache, dizziness, slow or irregular heartbeat and codeine when administrated along with meraprel shows additive property to the side effects of metaprel and may result in lowering blood pressure or irregular heartbeats. Moduretic is a diuretic drug that helps in excreting excessive fluids and salts from the body. Moduretic is a drug used to treat high blood pressure by reducing the extra fluid amount in the body on other hand morphine may reduce the efficacy of moduretic as it induces release of antidiuretic hormones. Demerol has a potential risk of interacting dangerously with monoamine oxidase inhibitors on other hand nardil is monoamine oxidase inhibitor. Combination of Demerol and nardil can increase the risk of respiratory depression and low blood pressure. In rare conditions it may cause serotonin syndrome syndrome and severe conditions may result in coma or fatal side effects.

Opioid analgesics are used as pain reliever associated with trauma, cancer, biopsy, or appendicitis pain. They are effective for moderate to severe pains (acute and chronic pain). Opioids are extracted from natural opium or synthetic chemicals. It can also be known as narcotic analgesics. Some effective opioid drugs are codeine, heroin, meperidine, oxycodone, etc. There is always an adverse effect for the overdose of a drug. Opioid analgesics have beneficial for relieving pain in the human body. Due to the chronic use of opioid analgesics, tolerance level with physical activities was affected. Opioid analgesics produce sedation and respiratory depression which causes tolerance. These effects are beneficial but the degree of pain remains unchanged. For pain relief, one can increase the dose of an opioid, known as analgesic tolerance, which is not beneficial. So, opioid analgesics produces respiratory depression with long term use of doses. Hence, option (a) is an incorrect statement. Opioid antagonists are attached to opioid receptors and the displacement of analgesics occurs, which causes severe respiratory depression. There are two types of antagonists, pure and partial antagonists. Pure antagonists include naloxone and nalmefene, responsible for the competitive blocking of drugs. Partial antagonists include pentazocine, butorphanol and nalbuphine, responsible for producing weak effects like morphine. Endorphine means endogenous and morphine. It produced within the pituitary and hypothalamus. It interacts with the opioid receptors to produce the analgesic effects within the body. Hence, option (b) is an incorrect statement. Drugs having moderate abuse potential used for medical treatment is known as schedule III drugs. Due to abuse potential, opioids are controlled substances. In a very early time, opioids are under schedule II drug having high abusive potential. But heroin comes from morphine in the late nineteenth century, is three times more potent and addicting. Due to this reason, heroine restricted to the schedule I category. Codeine has less abuse potential, was restricted to schedule III and V. So, all drugs in the opioid analgesics are not in schedule III. Hence, option (c) is an incorrect statement. Opioid antagonists are attached to opioid receptors and the displacement of analgesics occurs, which causes severe respiratory depression. There are two types of antagonists, pure and partial antagonists. Pure antagonists include naloxone and nalmefene, responsible for the competitive blocking of drugs. Partial antagonists include pentazocine, butorphanol and nalbuphine, responsible for producing weak effects like morphine. Fentanyl is a major opioid analgesic, responsible for sedation to reduce apprehension. Hence, the option (e) is an incorrect statement. Nausea and emesis were produced due to low doses of opioid analgesics. Vomiting activates the kappa or delta receptors, stimulates the trigger zone of chemoreceptor in the central nervous system, causing stimulation of vomiting center in the medulla. Hence, the correct statement is option img .

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