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NURS 251 Pharmacology Final Exam NEW 2023- Portage Learning A+
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NURS 251 Pharmacology Final Exam NEW 2023- Portage LearningNURS 251 Pharmacology
Final Exam+ NEW 2023-
Portage Learning
, NURS 251 Pharmacology Final Exam NEW 2023- Portage Learning
251 Pharmacology Final
Exam
Module 10
Opioid Tolerance: Develops for euphoria, respiratory depression, nausea. Does NOT develop for constipation or miosis.
Opioid Physical Dependence: Substantial for opioids. Abstinence syndrome extremely unpleasant but rarely dangerous. Protracted withdrawal
may persist for months and characterized by insomnia, irritability and fatigue.
OUD Maintenance Therapy Opioid Overdose Reversal
Drug Class Pure Opioid Agonist Partial Mu Agonist, Kappa Pure Opioid Antagonist Pure Opioid Antagonist
Antagonist
Prototype Methadone Buprenorphine Naltrexone Naloxone
MOA Replaces/substitutes the misused Replaces/substitutes the misused Discourages opioid use by Reverses respiratory and CNS
opioid opioid blocking euphoria/effects depression
Therapeutic OUD withdrawal/detox, OUD OUD withdrawal/detox, OUD AUD, OUD (after detox) Reversal agent for overdose,
Uses maintenance/suppressive therapy, maintenance/suppressive post-op effects, neonate resp.
pain management therapy, pain management depression
, NURS 251 Pharmacology Final Exam NEW 2023- Portage Learning
AEs Standard opioid AEs; QT prolongation; HA; GI upset; anxiety; sleep GI; HA, sedation, anxiety; Reversal of pain control,
respiratory depression; hepatic injury disturbances; LE edema; sweating injection-site rxns; liver withdrawal if physically
toxicity dependent on opioids
Nursing CII Controlled Substance CIII Controlled Substance MUST be opioid-free (- urine) Titrate carefully to prevent
Implications Baseline ECG, routine thereafter for Administer tablets and film Manufacturer provided withdrawal/loss of pain
cardiac hx; report sx of liver injury; sublingually needles in gluteal muscle control
monitor VS and dose sufficiency to Greater risk of death if relapse Greater risk of death if Monitor for 4+hrs after
suppress withdrawal after discontinuation relapse after discontinuation overdose
Greater risk of death if relapse after effectiveness with counseling effectiveness with counseling Teach proper admin
discontinuation technique based on product
effectiveness with counseling prescribed
Other PK: LONG half-life and duration of IV: PMH/FH of QT prolongation. IV: contraindicated in acute PK: SHORT half-life, onset 2-
action, cross tolerance to other opioids PREFERRED in pregnancy alone. hepatitis/liver failure; NOT 5mins, duration; hours,
IV: PMH/FH of QT prolongation. May DDIs: Strong inducer/inhibitors used in pregnancy STRONG mu binding, NOT PO
be used in pregnancy of CYP3A4, CNS depressants DF: Monthly IM injection. (1st pass)
DDIs: CNS depressants, QT-prolonging Safety: Ceiling effect: lower Preferred in OUD DF: SubQ/IM/IV, IN
drugs, CYP3A4 inhibitors abuse/respiratory depression (� DDIs: Opioids (no others) DDIs: opioids
Safety: Accumulation/respiratory with concomitant CNS
, NURS 251 Pharmacology Final Exam NEW 2023- Portage Learning
depression with repeat dosing, only depressants) Pain management may be
prescribed for OUD through opioid tx difficult given drug properties
program (exception for 72hrs of IP Can precipitate withdrawal Can precipitate withdrawal
use)
Opioid Overdose Risk Factors*
AUD: Chronic, relapsing disorder characterized by: impaired control over drinking, preoccupation with consumption, use of alcohol despite
awareness of adverse consequences, distortions in thinking, esp. aeb denial of problem.
Influenced by genetics, psychosocial, and environmental factors. May lead to psychological issues, malnutrition, poor work performance,
family/social deterioration, and health consequences.
Alcohol Withdrawal Syndrome: Begins 4-12hrs after last drink. May continue for 5-7 days. [N/V, tremors, restlessness, insomnia, depression,
irritability, HR/BP/temp/RR, diaphoresis, seizures, illusions]
Alcohol Withdrawal Delirium: 2-3 days after abrupt withdrawal. < MEDICAL EMERGENCY
Withdrawal Maintenance
Drug Class Benzodiazepines Aversion Therapy Pure Opioid Antagonist
cologne, etc.
Prototype Disulfiram Naltrexone Acamprosate
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