MOA

Indicati
ons

Opioid Analgesics
Bind to receptors in CNS periphery and GI tract =
analgesia, sedation, and sense of well being
Moderate to severe pain
Cough, decreased bowel motility
Status Post MI and for PE

Opioid Agonist-Antagonist
Partially bind to opiate receptor in CNS = analgesia,
sedation, decreased GI motility less than opioids
Moderate to severe pain
TX of opioid dependence
Balanced Anesthesia
Labor & Delivery
Sedation
Respiratory depression
Dizziness
Increased ICP
Psychosis
Abstinence Syndrome

Opioid Antagonist
Competitively blocks the effects of opioids

HX of MI
Dependent of Opioids
Renal/Liver
Respiratory depression
Head Injury

Hypersensitivity
Opioid dependence

Nalmefene (Revex)
Naloxone (Narcan)
Naltrexone (Revia)

AE

Orthostatic Hypertension
Sedation
Urinary Retention
Constipation
Respiratory depression
Opioid overdose triad

Contrai
ndicati
ons

Allergy, severe asthma

Meds

Dilaudid
Demerol
MScontin
Percocet
Percodan

Stadol
Nubain
Talwin
Bupranex

Interact
ions

Other CNS depressants

Anticholinergics

Other CNS depressants

Anticholinergics

Nur
Implica
tions

Monitor VS
Respiratory depression
History of drug usage
Pain scale dont wait until pain is severe
Monitor GI
I/O
Monitor therapeutic effects

Monitor VS
Respiratory depression
History of drug usage
Monitor GI
I/O
Monitor therapeutic effects
Abstinence Syndrome
Safety

Caution:
Head injury,
Renal/hepatic
CNS depression
Pregnant & Lactating

Reverse CNS depression

Naltrexone=management of ETOH and narcotic
dependence
N/V
Tachycardia
Tachypnea
Arrhythmias
Abstinence Syndrome = Cramping, HTN, and
Vomiting

Assess LOC
Respiratory Rate (may need to repeat dose)
Tell patient pain will return
Monitor Respiratory status