Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction to Clinical
Pharmacology
Chapter 17-
O...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid (Narcotic) Antagonists
• Actions
– Antagonis...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid (Narcotic) Antagonists (cont’d)
• Uses
– Pos...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid (Narcotic) Antagonists (cont’d)
• Contraindi...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Assessment
• Preadministration ass...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Fluoroquinolones: Adverse Reactions
• Common advers...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Assessment
• Preadministration ass...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Assessment (cont’d)
– Obtain blood...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Assessment (cont’d)
• Ongoing Asse...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Assessment (cont’d)
• Nursing Aler...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Planning and
Implementation
• Plan...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Planning and
Implementation (cont’...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Planning and
Implementation (cont’...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Nursing Process: Evaluation
• The therapeutic effec...
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
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Ppt chapter017

  1. 1. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Clinical Pharmacology Chapter 17- Opioid Antagonists
  2. 2. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Opioid (Narcotic) Antagonists • Actions – Antagonist: Competes for opiate receptor sites – Reverses all effects, pain will return – No opioid: Antagonist has no drug activity
  3. 3. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Opioid (Narcotic) Antagonists (cont’d) • Uses – Postoperative acute respiratory depression, reversal of opioid adverse effects, suspected acute opioid overdosage • Adverse Reactions – Nausea, vomiting, sweating, tachycardia, increased blood pressure, tremors
  4. 4. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Opioid (Narcotic) Antagonists (cont’d) • Contraindications, precautions, interactions – Hypersensitivity, pregnancy category B, infants of opioid-dependent mothers, patients with opioid dependency, cardiovascular disease, and lactation • Withdrawal symptoms: Opioid dependent
  5. 5. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Assessment • Preadministration assessment: – Long-term opioid therapy: Tolerant to physical adverse effects – Risk for respiratory depression – Somnolence and pain relief: Slows breathing pattern – Coach breathing pattern
  6. 6. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Fluoroquinolones: Adverse Reactions • Common adverse effects – Nausea, diarrhea, headache, abdominal pain, dizziness • Serious adverse effects – Photosensitivity and hypersensitivity – Bacterial or fungal superinfections – Pseudomembranous colitis
  7. 7. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Assessment • Preadministration assessment: – Long-term opioid therapy: Tolerant to physical adverse effects – Risk for respiratory depression – Somnolence and pain relief: Slows breathing pattern – Coach breathing pattern
  8. 8. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Assessment (cont’d) – Obtain blood pressure, pulse and respiratory rate – Review record for drug suspected of causing respiratory depression symptoms – Review initial health history, allergy history, treatment modalities
  9. 9. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Assessment (cont’d) • Ongoing Assessment – Monitor: Blood pressure, pulse, and respiratory rate at frequent intervals, vital signs every 5-15 minutes after patient responsive – Adverse drug reactions: Notify primary health care provider – Continue to monitor vital signs until effects of opioid wear off
  10. 10. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Assessment (cont’d) • Nursing Alert – Repeated dose needed if results from initial dose unsatisfactory – Duration of close patient observation depends on response to opioid antagonist
  11. 11. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Planning and Implementation • Planning – Return to normal respiratory rate, rhythm, depth, adequate ventilation of body, continued pain relief • Implementation: Promoting an Optimal Response to Therapy – Naloxone: Used in postanesthesia recovery unit – Balance pain relief
  12. 12. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Planning and Implementation (cont’d) • Monitoring and Managing Patient Needs – Impaired Spontaneous Ventilation •Naloxone: Cardiac monitoring, artificial ventilation, suction equipment, maintain patent airway •Naloxone by IV infusion: Secondary line, IV piggyback, IV push
  13. 13. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Planning and Implementation (cont’d) • Nursing Alert – Slow IV push: Somnolence abates • Acute Pain – Assess pain and begin to treat pain again, review circumstances that led to use of antagonist, educate family, monitor fluid intake and output
  14. 14. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Process: Evaluation • The therapeutic effect is achieved • The patient’s respiratory rate, rhythm, and depth are normal • Pain relief is resumed
  15. 15. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation
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