Opioid is a chemical substance that has a morphine-like action in the body. It is use mostly for pain relief. Opioid works by binding to opioid receptors in the central nervous system and the gastrointestinal tract. The receptors in these two organ systems mediate both the beneficial effects, and the undesirable side effects.
Classes of opioids:
- natural opiates, alkaloids contained in the resin of the opium poppy including morphine, codeine and thebaine, but not papaverine and noscapine which have a different mechanism of action;
- semi-synthetic opiates, created from the natural opioids, such as hydromorphone, hydrocodone, oxycodone, oxymorphone, desomorphine, diacetylmorphine (Heroin), nicomorphine, dipropanoylmorphine, benzylmorphine and ethylmorphine;
- fully synthetic opioids, such as fentanyl, pethidine, methadone, tramadol and propoxyphene;
- endogenous opioid peptides, produced naturally in the body, such as endorphins, enkephalins, dynorphins, and endomorphins.
Effect of Substance:
Temporary sense of well being, drowsiness, poor coordination, light-headedness, impaired thought processes, memory difficulty, confusion
Effect of Withdrawal:
Anxiety, gastrointestinal distress, nausea, insomnia, muscle pain, fever and chills, runny nose and eyes, sweating, tachypnea, coma, pintpoint pupils
Treatment:
- Detoxification
- Drugs: Opiate antagonis naloxone (Narcan) IV in emergency situation.
- In morphine and heroin addicts can use methadone daily to stabilize patient.
- In other opioid addicts, slowly taper the abused opioid.
- Psychotherapy
- Halfway houses
- Day or night hospitalization
- Twelve-step support groups
Nursing Intervention:
- Maintain airway
- Maintain safety
- Do not leave patient unattended because of risk of lapsing into coma quickly
- Monitor and assess for pulmonary edema
- Monitor vital sign and neurologic status and report to physician any abnormal redings
- Provide a quiet environment
- Encourage patient to express fears and anxiety
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