Narcotic Analgesics and Anesthesia Drugs

1
Narcotic Analgesics and Anesthesia Drugs

• Narcotic Analgesics

2
Opioids

• Actions
• Analgesia
• Euphoria
• Sedation

3
Opioids

• Primary Use
• Moderate Pain
• Severe Pain
• Acute Pain
• Chronic Pain
• Breakthrough Pain

4
Opioids

• Other Uses
• Pre-Op Sedation
• Adjunct Anesthesia
• Anti Anxiety
• Diarrhea
• Opiate Dependence

5
Opioids

• Common Opioids
• Morphine sulfate
• Codeine
• meperidine HCl (Demerol)
• hydromorphone (Dilaudid)
• fentanyl (Duragesic)
• oxycodone (OxyContin)

6
Opioids

• Common Routes
• IV
• IM
• Subcutaneous
• Oral
• Transdermal
• Epidural

7
Opioids

• Adverse Reactions

Euphoria, dysphoria, confusion, sedation
Respiratory depression, cough depression
Nausea, vomiting, constipation
Hypotension, bradycardia or tachycardia
Urinary hesitancy, dysuria
Allergic reactions, pruritis
Pain, irritation at injection site
8
Opioids

• Contraindications

Opiate allergies
Pulmonary diseases (asthma, COPD)
Head injuries, increased intracranial pressure
Convulsions
Ulcerative colitis
Renal or hepatic dysfunction
9
Opioids

• Precautions

Not recommended during labor
Not recommended during lactation
Use caution with elderly
Not recommended for biliary surgery
10
Opioids

• Precautions

Opioid Naive
Tolerance
Addiction
11
Opioids

• Precautions

Opioids and Acetaminophen
Daily acetaminophen intake should NOT EXCEED 4
grams
12
Opioids

• Interactions

CNS Depressants
Use caution whenever two or more CNS depressants
given
13
Opioids

• Special Circumstances

Opiates of Choice
Codeine Persistent Cough
Morphine Myocardial Infarct
Meperidine Biliary Surgery
14
Opioids

• Opiate Poisoning

miosis
hypoxia
Respirations lt 10 / min
15
Opioids

• Opiate Antagonist

16
Opioids

• Patient Controlled Analgesia (PCA)

17
Opioids

• Epidural

18
Opioids

• Transdermal