- Body system
- Pain
- Name stem
- -codone, -morphone
- Drug cards
- 2 in this guide
Drugs in this class
Other examples: Hydromorphone, Oxycodone, Hydrocodone, Fentanyl, Methadone, Buprenorphine, Tramadol.
How opioid analgesics and antagonists work
Opioid agonists stimulate mu receptors in the brain and spinal cord. Naloxone is a pure antagonist; buprenorphine is a partial agonist.
Uses
- Moderate to severe acute pain
- Cancer and end-of-life pain
- Opioid use disorder (methadone, buprenorphine)
- Opioid overdose reversal (naloxone)
Adverse effects
- Respiratory depression
- Sedation
- Constipation (does not improve with time)
- Nausea and vomiting
- Hypotension
- Urinary retention and itching
- Tolerance, dependence and addiction
Nursing considerations
- Assess pain, respiratory rate, oxygen saturation and sedation before and after each dose; use a sedation scale.
- Hold and notify for excessive sedation or a low respiratory rate; keep naloxone available.
- Start a bowel regimen. Never crush long-acting forms. Fentanyl patches are only for opioid-tolerant patients.
Patient teaching
- Avoid alcohol, benzodiazepines and sleep aids.
- Store securely and dispose of unused medicine properly.
- Keep naloxone at home.
Opioid analgesics and antagonists NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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After a dose of IV morphine, a patient is difficult to arouse with a respiratory rate of 8. What is the priority action?
Show answer
Answer A: Stimulate the patient, support breathing and give naloxone as ordered This is opioid-induced respiratory depression. Support the airway and breathing and give naloxone per protocol.
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Which adverse effect of opioids does not lessen with continued use?
Show answer
Answer D: Constipation Tolerance develops to most opioid effects but not to constipation, so a bowel regimen is needed for the whole course.
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Why must a patient who received naloxone be monitored closely?
Show answer
Answer A: Naloxone may wear off before the opioid, and sedation can return Naloxone's duration is shorter than that of many opioids, so respiratory depression can recur.
Frequently asked questions
What are opioid analgesics and antagonists?
Opioids are the strongest analgesics. Respiratory depression is the danger, sedation is its warning sign, constipation is constant, and naloxone is the reversal agent.
How do opioid analgesics and antagonists work?
Opioid agonists stimulate mu receptors in the brain and spinal cord. Naloxone is a pure antagonist; buprenorphine is a partial agonist.
What are examples of opioid analgesics and antagonists?
Morphine, Naloxone, Hydromorphone, Oxycodone, Hydrocodone, Fentanyl, Methadone and Buprenorphine.
What are the nursing considerations for opioid analgesics and antagonists?
Assess pain, respiratory rate, oxygen saturation and sedation before and after each dose; use a sedation scale. Hold and notify for excessive sedation or a low respiratory rate; keep naloxone available.