Opioid equianalgesic basics, reversal agents, benzodiazepines, propofol, ketamine, neuromuscular blockers and respiratory monitoring.
40 cards · basic cards · AI-written, checked twice. Edit anything.
- What is the standard equianalgesic reference dose used for IV morphine?
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10 mg IV- What is the approximate oral-to-IV potency ratio for morphine?
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About 3:1 (the oral dose is about 3 times the IV dose for the same effect)- About how many times more potent is fentanyl than morphine?
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About 100 times more potent- About how many times more potent is hydromorphone (Dilaudid) than morphine?
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About 5 to 7 times more potent- What is the classic triad of signs seen in opioid overdose?
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Pinpoint pupils (miosis), respiratory depression, and decreased level of consciousness- Why is meperidine (Demerol) avoided for long-term use or in renal impairment?
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Its metabolite normeperidine accumulates and can cause CNS excitation and seizures- Does tolerance develop to opioid-induced constipation?
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No, tolerance does not develop, so a stimulant laxative or stool softener should be given prophylactically- Why is codeine considered a prodrug?
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It must be converted by the liver enzyme CYP2D6 into morphine to produce its analgesic effect- Why does methadone carry a risk of delayed respiratory depression?
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Its half-life is much longer than its analgesic duration, so it can accumulate with repeated dosing- Why are transdermal fentanyl patches contraindicated in opioid-naive patients?
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The dose is too high for someone without opioid tolerance and can cause fatal respiratory depression- What drug is the first-line reversal agent for opioid-induced respiratory depression?
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Naloxone- Why might a patient need repeated doses of naloxone after an opioid overdose?
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Naloxone's duration of action is shorter than many opioids, so sedation and respiratory depression can return- Below what respiratory rate should a nurse typically hold a scheduled opioid dose and notify the provider?
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Below about 12 breaths per minute- What risk does giving naloxone to an opioid-dependent patient carry?
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It can precipitate acute opioid withdrawal symptoms- What drug is used to reverse benzodiazepine sedation?
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Flumazenil
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