Buprenorphine - ATI Med card PDF

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ATI Med card...

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ACTIVE LEARNING TEMPLATE:

Medication

Keisha Carpentier STUDENT NAME _____________________________________ buprenorphine MEDICATION __________________________________________________________________________

REVIEW MODULE CHAPTER ___________

Pharm.: opioid Therap.: opioid analgesic Preg.: C CATEGORY CLASS ______________________________________________________________________ PURPOSE OF MEDICATION

Expected Pharmacological Action Binds to opiate receptors in the CNS. Alters the perception of and response to painful stimuli while producing generalized CNS depression. Has partial antagonist properties that may result in opioid withdrawal in physically dependent pts when used as an analgesic.

Therapeutic Use Decreased severity of pain. Suppression of withdrawal symptoms during detoxification and maintenance from heroin or other opioids. Continued cessation of opioid use.

Complications CNS: confusion, dysphoria, hallucinations, sedation, unusual dreams, euphoria CV: HTN, hypotension, palpitations, QT interval prolongation EENT: blurred vision, diplopia, miosis ENDO: adrenal insufficiency GI: hepatotoxicity, n/v, constipation, dry mouth, ileus GU: urinary retention RESP: respiratory depression SKIN: sweating, clammy, erythema, pruritis, rash OTHER: hypersecnsitivity, injection site reactions, physical dependence, psychological dependence, tolerance

Medication Administration IM: onset- 15 mins, peak- 60 mins, and duration- 4-6 hrs IV: onset- rapid, peak: < 60 mins, and duration- 4-6 hrs Transdermal: onset and peakunknown and duration- 7 dys SL, Buccal, Subdermal, and SubQ: onset, peak, and duration: unknown

Contraindications/Precautions CONTRAINDICATED: Hypersensitivity, significant respiratory depression, acute or severe bronchial asthma, paralytic ileus, acute, mild, intermittent, or postoperative pain, long QT syndrome, concurrent use of class 1 or 3 antiarrhythmics, lactation CAUTIOUSLY: increased ICP, compromised respiratory function, severe renal impairment, moderate or severe hepatic impairment, hypothyroidism, seizure disorders, adrenal insufficiency, alcoholism, biliary tract disease, acute pancreatitis, debilitated pts, oral mucositis, undiagnosed abdominal pain, hypokalemia and -magnesemia, unstable atrial fibriliation, symptomatic bradycardia, unstable HF, MI, prostatic hyperplasia, pregnancy, and peds and gero ptsqt

Interactions DRUGS: Class 1a and class 3 antiarrhythmics, QT intreval prolonging meds, benzodiazepines, CNS depressants, other opioids, nonbenzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, MAOIs, opioid analgesics, itraconazole, ketoconazole, erythromycin, ritonavir, indinavir, saquinavir, atazanavir, fosamprenavir, carbamazepine, rifampin, phenytoin, trycyclic antidepressants, SSRIs, SNRIs, TCAs, tramadol, trazodone, mirtazapine, 5-HT3 receptor antagonists, linezolid, methylene blue, triptans FOODS/HERBALS: alcohol, kava-kava, valerian, chamomille, hops

Nursing Interventions Monitor for SxS of adrenal insufficiency. Use and equianalgesic chart when changing routes or switching to another opioid. Explain that for the med to be most effective if given before pain becomes severe. Have pt wet inside of cheek, before applying buccal film; and inform them not to swallow or chew the film. Rotate sites for IM injections. Know that it can cause withdrawal in pts who are already taking opioids.

Client Education Evaluation of Medication Effectiveness Decrease in severity of pain w/o a significant alteration in LOC or respiratory status. Suppression of withdrawal symptoms during detoxification and maintenance from heroin or other opioids.

ACTIVE LEARNING TEMPLATES

Instruct on risk of addiction, abuse, and misuse; and how it can lead to death. Advise to have assistance ambulating and to not do anything else that requires concentration, because it can cause drowsiness or dizziness. Encourage that if on bedrest to turn, cough, and deep-breathe every couple of hrs. Instruct to change positions slowly to prevent orthostatic hypotension. Advise to perform good oral hygiene, frequent mouth rinses, and using sugarless gum or candy to cecrease dry mouth.

THERAPEUTIC PROCEDURE

A7...