What characterizes opioid analgesia in intensity, duration, and dose dependence?
It is intense, constant, and dose-dependent.
Which types of pain can opioids relieve?
All types of pain.
Which effects are inhibitory effects of opioids?
Analgesia, respiratory depression, and somnolence.
Which effects are excitatory effects of opioids?
Miosis, nausea, and vomiting.
Which respiratory responses do opioids depress?
Responses to hypoxia and hypercapnia.
How is morphine administered by titration?
As a 2 mg bolus every 5 minutes.
When does intravenous morphine begin acting?
After 15 minutes.
When does intravenous morphine reach its maximum effect?
After 20–30 minutes.
How long does intravenous morphine act, with residual effects reported up to what duration?
It acts for 2–3 hours, with residual effects reported up to 4 hours.
How potent is alfentanil relative to morphine?
30 times as potent.
What induction dose does the source give for fentanyl?
3–5 μg/kg.
What is the listed duration for fentanyl?
20–30 minutes.
Which conditions are listed as contraindications to morphine?
Respiratory, renal, or hepatic insufficiency; asthma; age under 30 months; convulsive state; acute alcohol intoxication; delirium tremens; coma; head trauma; and intracranial hypertension because of hypoventilation.
What respiratory measure is monitored during morphine treatment?
Respiratory rate.
Which neurological effects are monitored during morphine treatment?
Central nervous system depression and sedation level.
Which pain-related measures are monitored during morphine treatment?
Analgesia and pain level.
What other treatment effects are monitored during morphine treatment?
Adverse effects.
Which drug is listed as the opioid antidote?
Naloxone (Narcan).
Which urinary effect of opioids occurs in 10–20% of cases?
Urinary retention.
Which gastrointestinal effects can opioids cause?
Nausea, vomiting, constipation, and increased biliary tract pressure.
What indicates physical dependence after opioid treatment stops?
Withdrawal symptoms.
What psychomotor effects can opioids cause?
Psychomotor excitation or sedation.
How do opioids affect vigilance and hypnosis?
They reduce vigilance but do not produce hypnosis.
How can opioids cause thoracic rigidity?
By decreasing thoracic compliance.
How much morphine does a 1 ml ampoule contain?
10 mg.
Which organ metabolizes morphine?
The liver.
Through which routes is morphine eliminated?
Through the kidneys, milk, bile, and stools.
What is one indication for morphine?
Postoperative analgesia.
How are alfentanil, fentanyl, and sufentanil metabolized?
Hepatically.
How are alfentanil, fentanyl, remifentanil, and sufentanil eliminated?
Renally.
What maintenance dose does the source give for fentanyl?
1–3 μg/kg.
What is the listed onset time for fentanyl?
30 seconds to 1 minute.
Which administration routes are listed for fentanyl?
Epidural, intramuscular, and subcutaneous.
When is morphine contraindicated during pregnancy?
At the end of pregnancy.
What three respiratory or eye effects can opioids cause?
Reduced intraocular pressure, bronchoconstriction, and cough-reflex depression.
What is dose-dependent about morphine’s histamine release?
Its marked histamine release.
What effects of morphine accompany its marked histamine release?
Pruritus and headaches.
How does fentanyl affect heart rate and blood pressure?
It markedly decreases heart rate and lowers blood pressure by 15–20%.
What does psychological dependence mean?
Dependence of a psychological nature.
Answer 13 questions on Morphine and Synthetic Opioids.
1. Which description best characterizes opioid analgesia?
2. A patient receiving an opioid develops pinpoint pupils, nausea, and vomiting. How are these effects classified?
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