Opiates and Opioids

10 Questions

What is the main purpose of routine observations for a patient receiving narcotics?

To monitor respiratory rate, depth, effort, heart rate, blood pressure, and sedation score

What are the potential interactions of narcotics with anti-hypertensive drugs?

Increase antihypertensive effect, e.g., may cause hypotension and bradycardia

What is the effect of narcotics on mood?

Alters mood

What is the impact of narcotics on sleep/drowsiness?

Usually induces sleep/drowsiness

What is the significance of acknowledging the Traditional Owners of lands across Australia?

To recognize and respect their Elders, Ancestors, cultures, and heritage

Which opioid is a natural opiate and is the most effective analgesia for severe pain?

Morphine

Which synthetic opioid is more potent than morphine and is used for short-term management of moderate to severe pain or aiding in opiate withdrawal?

Buprenorphine

Which opioid is usually administered orally for pain relief and cough suppression, with different dosages falling into different drug schedules?

Codeine

Which synthetic opioid should not be combined with paracetamol and can cause severe respiratory depression leading to death in overdose?

Dextropropoxyphene

Which opioid is available as transdermal patches and lozenges for chronic pain disorders and can be given IM and IV for pre-med and post-op pain?

Fentanyl

Study Notes

Opiates and Opioids: Key Information

Opiates and opioids activate opioid receptors in the CNS and PNS, causing analgesia, respiratory depression, and sedation.
Morphine, a natural opiate, is the most effective analgesia for severe pain and is available in various routes of administration with different onset, peak, and duration times.
Buprenorphine is a synthetic opioid more potent than morphine, used for short-term management of moderate to severe pain or aiding in opiate withdrawal.
Codeine, a less potent opiate, is usually administered orally for pain relief and cough suppression, with different dosages falling into different drug schedules.
Pethidine, a synthetic opioid analgesic, is used for moderate to severe pain in obstetrics, post-op, and anesthesia, with adverse effects including drowsiness and respiratory depression.
Dextropropoxyphene, a synthetic opioid similar in potency to codeine, should not be combined with paracetamol and can cause severe respiratory depression leading to death in overdose.
Semi-synthetic opioids with longer half-lives than morphine are available in tablet form and controlled release tablets for patients with swallowing difficulties.
Oxycodone with naloxone controlled release is used for severe pain not responding to non-opioid analgesia, with naloxone blocking opioid receptors in the gut to reduce constipation.
Fentanyl, a potent opioid analgesic, is available as transdermal patches and lozenges for chronic pain disorders and can be given IM and IV for pre-med and post-op pain.
Tramadol, effective for moderate postoperative pain, has similar side effects to opioids but less respiratory depression, with naloxone reversing respiratory depression.
Opioid receptor antagonists, such as naloxone, compete at opioid receptors to displace opioids, reversing their effects, but may exacerbate pain and precipitate withdrawal.
Monitoring of sedation and respiratory rate is crucial for assessing the effectiveness of post-analgesia CNS, with the aim to keep sedation score below 2 and reduction of respiratory rate being a late indicator of overdose.