What are the nurses responsibilities when administering an opioid analgesic?
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Department: MEDICATION ERRORS: 10 TIPS ON SAFE OPIOID ADMINISTRATION COHEN, MICHAEL R. RPH, MS, ScD President of the Institute for Safe Medication Practices The reports described in Medication Errors were received through the USP-ISMP Medication Errors Reporting Program. Report errors, close calls, or hazardous conditions to the Institute for Safe Medication Practices (ISMP) at http://www.ismp.org or the United States Pharmacopeia (USP) at http://www.usp.org. You can also call ISMP at 1-800-FAIL SAFE or send an e-mail message to [email protected]. Michael R. Cohen is a member of the Nursing2007 editorial advisory board. Nursing 37(5):p 14, May 2007. | DOI: 10.1097/01.NURSE.0000268748.58433.6a
In BriefMatching drug to disease … topical medication given I.V. … 10 tips for safe opioid administration Opioids are powerful analgesics that are derived from the opium poppy plant. They are recognised as central in the management of acute pain and cancer pain, but concerns about long-term use have resulted in recommendations that they should be used with caution in the management of chronic pain. Opioids have associated side effects and risks, but these may be exaggerated and some healthcare professionals can be unnecessarily cautious and withhold the use of opioids, even in cases where these medicines may be beneficial. It is important that nurses understand the pharmacology, side effects and risks of opioids, so they can ensure these medicines are administered safely. Nursing Standard. doi: 10.7748/ns.2020.e11534 Peer reviewThis article has been subject to external double-blind peer review and checked for plagiarism using automated software @angelatelford12 CorrespondenceConflict of interestNone declared Telford A (2020) Role of the nurse in supporting the safe use of opioids. Nursing Standard. doi: 10.7748/ns.2020.e11534 On 1 April 2016 the statutory patient safety functions previously delivered by NHS England transferred with the national patient safety team to NHS Improvement Opioid analgesia is indicated for the treatment of moderate to severe pain. An opioid is a medication that relieves pain by binding to opioid receptors in the central nervous system spinal cord and peripheral nervous system. This guideline does not cover opioid delivery via patient controlled analgesia (PCA) delivery. AimTo provide medical and nursing staff at the Royal Children’s Hospital with a clear outline for assessment and management of a patient receiving opioids as an inpatient, including administration and adverse events associated with administration. Definition of Terms
PharmacologyThere are three main types of opioid receptors, these receptors have multiple actions:
Delta (d) receptors are involved with modulation of mu receptors. Primarily responsible for spinal analgesia Opioids are metabolised in the liver and excreted via the kidneys. Morphine is the most commonly used opioid of choice, and has two main metabolites M3G and M6G. M3G (morphine -3 glucuronide) has no analgesic action, but can cause neurotoxic effects such as tremor and myoclonus. M6G (morphine – 6 – glucuronide) is a powerful analgesic. Table 1: Side effects of opioids Neurological
Cardiovascular
Gastrointestinal/Renal
Musculoskeletal
Table 2: List of opioid medications Opioid generic name Medication information Morphine
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