Morphine Side Effects
Content
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Tylenol uses
Pain Fever
Tylenol action
Slows production of prostaglandins in the CNS
Side effects of Tylenol
Liver damage Early signs- N/V/D, sweating, and abdominal discomfo
rt progressing to liver failure, coma and death.
Limit on Tylenol per day
4gm
Antidote to Tylenol
Mucomyst (Acetylcystine)
Medication/food interactions for Tylenol
Alcohol (Inc. liver damage) Warfarin (Slows metab of warfarin leadin
g to inc levels)
Examples of Morphine Sulfate
Fentanyl, Demerol, Codiene, oxycodone
Morphine action
Acts on Mu receptors. Produces analgesia, resp depression, euphori
a, and sedation.
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Morphine uses
Pain, sedation, reduction of bowel motility
Side effects of Morphine
Resp depression, constipation, orthostatic hypotension, urinary rete
ntion, cough suppression, Sedation, biliary colic, emesis, opioid ove
rdose.
Morphine is contraindicated in
Premature infants
Repeated use of demerol results in
Accumulation of normeperidine. This can cause seizures and nephr
otoxicity. No more than 600mg/24 hours.
Med/food interactions for Morphine
CNS depressants, anticholonergic agents, MAOI's, Antihypertensives
Hold morphine if respirations are less than
12
Morphine reversal
Narcan
Fentanyl is _____x stronger than morphine
100
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Morphine classification
Opioid agonist
Pentazocine (Talwin) Butorphanol (Stadol) Classification
Agonists- antagonist opioid
Action of Agonists- antagonist opioids
Antagoists to mu receptors = analgesia, euphoria, resp depression,
sedation, dependance and decresed GI. Agonist to kappa = analges
ia, sedation and decreased GI.
Agonist- antagonist opioids are used for
Mild to mod pain
Side effects of agonist-antagonists
Abstinence syndrome (cramping, hypertension, and vomiting)
Example of opioid antagonist
Narcan
What is the action of Narcan?
Competes for opioid receptor sites
What is narcan used for?
To reduce effects of opioids such as resp depression, treatment of
opioid overdose
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Side effects of Narcan
Tachycardia, tachypnea, abstinence syndrome
Adjuvant medications for pain Examples
Tricyclic antidep- Elavil Anticonvul- Neurontin, dilantin CNS stim- Rita
lin Antihistam- Vistaril Glucocortico- Decadron, deltasone BiphosphAredia, etidronate
Action of adjuvant medications
Enhance the effects of opioids- Allows for lower doses of opioids
Uses of adjuvant medications
Neuropathic pain, cancer related conditions, relieves symptoms tha
t aggravate pain
Side effects of tricyclic antidepressants
Orthostatic hypotension, sedation, anticholonergic effects
Side effects of anticonvulsants
Bone marrow suppression
Side effects of CNS stimulants
Weight loss and insomnia
Antihistamine side effects
Sedation
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Glucocorticoid side effects
Adrenal insufficiency, osteoporosis, hypokalemia, glucose intoleranc
e, PUD
Biphosphonate side effects
Flu like symptoms, venous irritation and IV site
Examples of antigout medication
Colchicine, allopurinol, indocin, probenecid
Colchicine action
Decreases inflammation by preventing infiltration of leukocytes
Allopurinol action
Inhibits uric acid production
Probenecid action
Inhibits uric acid reabsorption by the renal tubules
Side effects of colchicine
GI toxicity, abdominal pain, N/V/D
Side effects of probenecid
Renal injury
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Med/food interactions with allopurinol
Warfarin (slows metabolism)
Med/food interactions with probenecid
Salicylates- lessens the effectiveness of probenecid
Foods to avoid with antigout medications
Alcohol and foods high in purine
Side effects of Ergot alkaloids
GI discomfort, Ergotism (muscle pain, cold pale extremities), phy de
pendence, abortion
Side effects of serotonin receptor antagonists
Chest symptoms, coronary vasospasm, tetrogenic
Side effects of beta blockers
Tiredness, fatigue, depression, and asthma exac
Anticonvulsant side effects
Neural tube defects
Tricyclic antidepressant side effects
Anticholonergic effects
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Calcium channel blocker side effects
Orthostatic hypotension, constipation
Contraindications of ergotamine
Renal or liver dysfunction, sepsis, CAD, and pregnancy
Medications for rheumatoid arthritis Examples
DMARDS Glucocorticoids Immunosuppressants NSAIDS
Action of DMARD
Slows joint degeneration and progression of RA
Side effects of cytotoxic agents
Hepatic fibrosis, bone marrow supression, GI ulceration, fetal death
Side effects of gold salts
Toxicity, blood dyscrasias, hepatitis, GI discomfort
Antimalarial side effects
Retinal damage
The gold standard opioid used for mod to severe pain?
Morphine sulfate
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
80-100 times more potent than morphine
Fentanyl
Opioid used for cough suppression
Codiene
Tricyclic depressant used for neuropathic pain
Amitriptyline (Elavil)
Imitrex is contraindicated for clients with
CAD
Which opioid should not be used for more than 48 hours?
Demerol
Treatment of parkinsons requires what two main classes of medica
tions?
Meds that activate dopamine receptors Meds that block acetylcholin
e receptors
Three main meds to treat bipolar
Lithium, valproic acid, and cabamazepine
Examples of neuromuscular blocking agents
Tubocurarine- Nondepolarizing Succinylcholine- Depolarizing
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Why are neuromuscular blocking agents used?
Used as adjuncts to general anesthesia to promote muscle relaxatio
n. Used to control spontaneous resp movements in clients on the ve
nt.
Succinylcholine is the preferred agent for (3)
Seizure control during electroconvulsive therapy, ET intubation, end
oscopy
Side effects of succs
Low pseudocholinesterase leads to apnea, malignant hypothermia,
hyperkalemia and after 12-24 hours post op may result in muscle p
ain in upper body and back.
Med/food interactions for neuromuscular blocking agents
General anesthesia, aminoglycosides, tetracycline, neostigmine and
other cholinesterase inhibitors.
Examples of dopaminergics
Levodopa, Sinmet, Levodopa Carbidopa
What does Levadopa do?
Crosses blood brain barrier and is taken up by dopaminergic nerve
terminals and is converted to dopamine. DA is then released into sy
naptic space and causes stim of DA receptors.
What does carbidopa do?
Inhibits conversion of levadopa to DA in intestine and periphery and
allows more levadopa to reach the CNS.
Examples of Dopamine agonists
Mirapex, Requip, Parlodel
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
What do dopamine agonists do?
Act directly on DA receptors
Examples of centrally acting muscle relaxants
Valium (Diazepam) Baclofen Flexeril Skelaxin
Action of centrally acting muscle relaxants
Acts in the CNS to enhance GABA and produce sedative effects
Examples of peripherally acting muscle relaxants
Valium Baclofen Dantrium
Action of peripherally acting muscle relaxants
Depresses spacticity
What are side effects of lidocaine?
Spinal headaches and urinary retention
Action of clozaril, risperdal, zyprexa, seroquel, abilify
Blocks serotonin and dopamine receptors. Also blocks receptors for
norepi, histamine, and acetylcholine.
Examples of SSRI's
Lexapro, celexa, zoloft, paxil, prozac
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Tylenol uses
Pain Fever
Tylenol action
Slows production of prostaglandins in the CNS
Side effects of Tylenol
Liver damage Early signs- N/V/D, sweating, and abdominal discomfo
rt progressing to liver failure, coma and death.
Limit on Tylenol per day
4gm
Antidote to Tylenol
Mucomyst (Acetylcystine)
Medication/food interactions for Tylenol
Alcohol (Inc. liver damage) Warfarin (Slows metab of warfarin leadin
g to inc levels)
Examples of Morphine Sulfate
Fentanyl, Demerol, Codiene, oxycodone
Morphine action
Acts on Mu receptors. Produces analgesia, resp depression, euphori
a, and sedation.
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Morphine uses
Pain, sedation, reduction of bowel motility
Side effects of Morphine
Resp depression, constipation, orthostatic hypotension, urinary rete
ntion, cough suppression, Sedation, biliary colic, emesis, opioid ove
rdose.
Morphine is contraindicated in
Premature infants
Repeated use of demerol results in
Accumulation of normeperidine. This can cause seizures and nephr
otoxicity. No more than 600mg/24 hours.
Med/food interactions for Morphine
CNS depressants, anticholonergic agents, MAOI's, Antihypertensives
Hold morphine if respirations are less than
12
Morphine reversal
Narcan
Fentanyl is _____x stronger than morphine
100
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Morphine classification
Opioid agonist
Pentazocine (Talwin) Butorphanol (Stadol) Classification
Agonists- antagonist opioid
Action of Agonists- antagonist opioids
Antagoists to mu receptors = analgesia, euphoria, resp depression,
sedation, dependance and decresed GI. Agonist to kappa = analges
ia, sedation and decreased GI.
Agonist- antagonist opioids are used for
Mild to mod pain
Side effects of agonist-antagonists
Abstinence syndrome (cramping, hypertension, and vomiting)
Example of opioid antagonist
Narcan
What is the action of Narcan?
Competes for opioid receptor sites
What is narcan used for?
To reduce effects of opioids such as resp depression, treatment of
opioid overdose
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Side effects of Narcan
Tachycardia, tachypnea, abstinence syndrome
Adjuvant medications for pain Examples
Tricyclic antidep- Elavil Anticonvul- Neurontin, dilantin CNS stim- Rita
lin Antihistam- Vistaril Glucocortico- Decadron, deltasone BiphosphAredia, etidronate
Action of adjuvant medications
Enhance the effects of opioids- Allows for lower doses of opioids
Uses of adjuvant medications
Neuropathic pain, cancer related conditions, relieves symptoms tha
t aggravate pain
Side effects of tricyclic antidepressants
Orthostatic hypotension, sedation, anticholonergic effects
Side effects of anticonvulsants
Bone marrow suppression
Side effects of CNS stimulants
Weight loss and insomnia
Antihistamine side effects
Sedation
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Glucocorticoid side effects
Adrenal insufficiency, osteoporosis, hypokalemia, glucose intoleranc
e, PUD
Biphosphonate side effects
Flu like symptoms, venous irritation and IV site
Examples of antigout medication
Colchicine, allopurinol, indocin, probenecid
Colchicine action
Decreases inflammation by preventing infiltration of leukocytes
Allopurinol action
Inhibits uric acid production
Probenecid action
Inhibits uric acid reabsorption by the renal tubules
Side effects of colchicine
GI toxicity, abdominal pain, N/V/D
Side effects of probenecid
Renal injury
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Med/food interactions with allopurinol
Warfarin (slows metabolism)
Med/food interactions with probenecid
Salicylates- lessens the effectiveness of probenecid
Foods to avoid with antigout medications
Alcohol and foods high in purine
Side effects of Ergot alkaloids
GI discomfort, Ergotism (muscle pain, cold pale extremities), phy de
pendence, abortion
Side effects of serotonin receptor antagonists
Chest symptoms, coronary vasospasm, tetrogenic
Side effects of beta blockers
Tiredness, fatigue, depression, and asthma exac
Anticonvulsant side effects
Neural tube defects
Tricyclic antidepressant side effects
Anticholonergic effects
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Calcium channel blocker side effects
Orthostatic hypotension, constipation
Contraindications of ergotamine
Renal or liver dysfunction, sepsis, CAD, and pregnancy
Medications for rheumatoid arthritis Examples
DMARDS Glucocorticoids Immunosuppressants NSAIDS
Action of DMARD
Slows joint degeneration and progression of RA
Side effects of cytotoxic agents
Hepatic fibrosis, bone marrow supression, GI ulceration, fetal death
Side effects of gold salts
Toxicity, blood dyscrasias, hepatitis, GI discomfort
Antimalarial side effects
Retinal damage
The gold standard opioid used for mod to severe pain?
Morphine sulfate
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
80-100 times more potent than morphine
Fentanyl
Opioid used for cough suppression
Codiene
Tricyclic depressant used for neuropathic pain
Amitriptyline (Elavil)
Imitrex is contraindicated for clients with
CAD
Which opioid should not be used for more than 48 hours?
Demerol
Treatment of parkinsons requires what two main classes of medica
tions?
Meds that activate dopamine receptors Meds that block acetylcholin
e receptors
Three main meds to treat bipolar
Lithium, valproic acid, and cabamazepine
Examples of neuromuscular blocking agents
Tubocurarine- Nondepolarizing Succinylcholine- Depolarizing
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
Why are neuromuscular blocking agents used?
Used as adjuncts to general anesthesia to promote muscle relaxatio
n. Used to control spontaneous resp movements in clients on the ve
nt.
Succinylcholine is the preferred agent for (3)
Seizure control during electroconvulsive therapy, ET intubation, end
oscopy
Side effects of succs
Low pseudocholinesterase leads to apnea, malignant hypothermia,
hyperkalemia and after 12-24 hours post op may result in muscle p
ain in upper body and back.
Med/food interactions for neuromuscular blocking agents
General anesthesia, aminoglycosides, tetracycline, neostigmine and
other cholinesterase inhibitors.
Examples of dopaminergics
Levodopa, Sinmet, Levodopa Carbidopa
What does Levadopa do?
Crosses blood brain barrier and is taken up by dopaminergic nerve
terminals and is converted to dopamine. DA is then released into sy
naptic space and causes stim of DA receptors.
What does carbidopa do?
Inhibits conversion of levadopa to DA in intestine and periphery and
allows more levadopa to reach the CNS.
Examples of Dopamine agonists
Mirapex, Requip, Parlodel
Pharm ATI
Study this set online at: http://www.cram.com/flashcards/pharm-ati-1784717
What do dopamine agonists do?
Act directly on DA receptors
Examples of centrally acting muscle relaxants
Valium (Diazepam) Baclofen Flexeril Skelaxin
Action of centrally acting muscle relaxants
Acts in the CNS to enhance GABA and produce sedative effects
Examples of peripherally acting muscle relaxants
Valium Baclofen Dantrium
Action of peripherally acting muscle relaxants
Depresses spacticity
What are side effects of lidocaine?
Spinal headaches and urinary retention
Action of clozaril, risperdal, zyprexa, seroquel, abilify
Blocks serotonin and dopamine receptors. Also blocks receptors for
norepi, histamine, and acetylcholine.
Examples of SSRI's
Lexapro, celexa, zoloft, paxil, prozac
