1 F ‘08 P. Andrews, Instructor. 2 We’ll talk about Buprenex Stadol Vicodin Demerol Morphine...
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Transcript of 1 F ‘08 P. Andrews, Instructor. 2 We’ll talk about Buprenex Stadol Vicodin Demerol Morphine...
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Buprenexbuprenorphine Class
Opioid analgesic (agonist – antagonist) Schedule V
Indications Management of moderate to severe pain
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Action Binds to opiate receptors in CNS (30x
morphine and 3x narcan) Alters perception of and response to
pain Produces generalized CNS depression
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Contraindications Hypersensitivity
Precautions Increased ICP
Adverse reactions, SE Nausea/Vomiting Dizzyness Headache Confusion Dysphoria Sedation Sweating
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Stadol butorphanol tartrate
Class Opioid analgesic (agonist/antagonist)
Indications Management of moderate to severe pain Analgesic during labor
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Action Binds to opiate receptors
in CNS Alters perception of
response to painful stimuli
Contraindications Hypersensitivity Opioid dependency
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Precautions Head trauma Increased ICP
Adverse reactions, SE Confusion Dysphoria Hallucinations Sedation Sweating Use with extreme
precautions in patient on MAO Inhibitors
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Vicodin (Anexia)hydrocodone bitartrate w/ acetaminophen Class
Analgesic Contains 5 mg narcotic, 500 mg
acetaminophen Schedule III
Indications Analgesic for moderate to severe pain
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Contraindications Hypersensitivity
Precautions Head injuries
Adverse reactions, SE Respiratory depression Sedation Dizziness Mental clouding Acetaminophen overdose may
result in potentially fatal hepatic necrosis
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Demerol meperidine hydrochloride
Class Opioid analgesic Schedule II
Indications Moderate or severe pain
Action Binds to opiate receptors in CNS
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Contraindications Hypersensitivity
Precautions Head injury Increased ICP
Adverse reactions, SE Seizures Confusion, sedation Hypotension Constipation N/V
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Route & dose 50 – 100 mg slow IV, SQ,
IM How supplied
10 mg/ml in 5 ml preload, 20 mg/ml, or 50 mg/ml in
5 ml preload
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MS ContinMorphine Sulfate
Class: Opioid analgesic Indications
Pulmonary edema Pain MI
Action Acts on opiate receptors to block sensation
of pain. Also causes peripheral vasodilation
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Contraindications Head injury Depressed respiratory drive Hypotension
Precautions: have intubation equipment and naloxone ready
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Dosage & Route
2-10 mg slow IVP q 3 - 5 min.
in 2 mg increments, titrated to
relief
How supplied
10 mg/ml in 1 ml tubex
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fentanyl
Class Opioid analgesic Schedule II
Indications Analgesia
Action Binds to opiate receptors in CNS, altering
response to and perception of pain
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Adverse reactions, SE Apnea
Laryngospasm
Route & dosage 50-100 mcg (0.05 – 0.1 mg)
How supplied 0.05 mg/ml in one ml preload
or tubex
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Nubainnalbuphine
Class Opioid analgesic (Agonist/antagonist)
Indication Moderate to severe pain
Action Binds to opiate receptors Alters perception of and response to
pain
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Route & dosage 10 mg g 3-6 h (not to
exceed 20 mg) IV How supplied
10 mg/ml in 1 and 10 ml vials or
20 mg/ml in 1 and 10 ml vials
1 ml preloads
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Trexannaltrexone
Class Opiate receptor agonist
Indications Alcoholics to decrease compulsive
consumption Detoxified addicts to stay opiate-free
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Action Competes for opiate receptors
Contraindications None noted
Precautions None noted
Adverse reactions, SE Abdominal cramps, H/A Depression irritability
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Route & dosage 25 mg tablets, PO; repeat
if no withdrawal sx in one hour
Alcohol dependence; 50 mg qd PO
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Narcannaloxone
Class Opioid antagonist
Indication Reversal of CNS depression and
respiratory depression 2ndary to opiate overdose
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Contraindications Hypersensitivity
Precautions Cardiovascular disease Pregnancy
Adverse reactions, SE None in emergent setting
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Nitronoxnitrous oxide
Class Analgesic
Indications Moderate to severe pain
Action Alters perception of pain Decreases hypoxia
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Contraindications Do not administer for
abdominal pain Severe head injury
Precautions Must be self-administered N/V
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Route & dosage Inhaled, blended mixture
of 50% nitrous oxide and 50% oxygen
Effects dissipate within 2-5 min. after cessation of administ.
Unit consists of oxygen & nitrous oxide cylinders, fed into blender; delivered to modified demand valve