Docmoates: Add medication infobox (Drugbox) to monographs

2026-06-17T16:09:36Z

Add medication infobox (Drugbox) to monographs

← Older revision		Revision as of 16:09, 17 June 2026
Line 1:		Line 1:
			{{Drugbox
			\| name = Opioids
			\| therapeutic = Opioid analgesic
			\| pharmacologic = Opioid agonists (morphine, hydromorphone, fentanyl, oxycodone, codeine, meperidine); tramadol and tapentadol are atypical opioids; buprenorphine is a partial agonist (controlled, most C-II)
			\| onset = IV minutes; oral 30 to 60 minutes; transdermal fentanyl over hours with long duration; ER products extended.
			\| halflife = Varies; no routine level; fentanyl very potent (micrograms).
			\| routes = PO (oral), IV, IM, SubQ, Transdermal, Rectal, Buccal
			\| highalert = <span style="color:#b00020;">'''Yes'''</span>
			\| blackbox = <span style="color:#b00020;">'''Yes'''</span> (see Safety)
			\| antidote = Naloxone.
			\| pregnancy = Use cautiously; risk of neonatal withdrawal.
			}}

	<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">		<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
	''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''		''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''

Docmoates: NCLEX nursing pharmacology monographs — batch import

2026-06-17T14:06:20Z

NCLEX nursing pharmacology monographs — batch import

New page

<div style="border-left:4px solid #3f6f5b;background:#f3f6f4;padding:8px 12px;margin-bottom:12px;font-size:0.95em;">
''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
</div>

'''Opioids''' — Opioid analgesic; Opioid agonists (morphine, hydromorphone, fentanyl, oxycodone, codeine, meperidine); tramadol and tapentadol are atypical opioids; buprenorphine is a partial agonist (controlled, most C-II).

== Identification ==
* '''Therapeutic class:''' Opioid analgesic.
* '''Pharmacologic class:''' Opioid agonists (morphine, hydromorphone, fentanyl, oxycodone, codeine, meperidine); tramadol and tapentadol are atypical opioids; buprenorphine is a partial agonist (controlled, most C-II).

== Pharmacology ==
* '''Mechanism of action:''' Bind mu opioid receptors to reduce pain perception and transmission.
* '''Onset / peak / duration:''' IV minutes; oral 30 to 60 minutes; transdermal fentanyl over hours with long duration; ER products extended.
* '''Half-life / therapeutic level:''' Varies; no routine level; fentanyl very potent (micrograms).

== Clinical use ==
* '''Indications:''' Moderate to severe pain; fentanyl also anesthesia; codeine also cough; specific agents for chronic pain.
* '''Usual dose, route, frequency:''' Titrated to pain by route; morphine PO, IV, IM, SubQ, rectal; fentanyl IV, transdermal, buccal.
* '''Maximum dose / adjustments:''' No fixed ceiling for pure agonists but titrate carefully; reduce in renal and hepatic impairment and the elderly; avoid meperidine in renal impairment and for chronic or repeated use (toxic metabolite causes seizures); transdermal fentanyl only for opioid-tolerant patients.

== Safety ==
* '''Contraindications:''' Severe respiratory depression, paralytic ileus, acute asthma; meperidine with MAO inhibitors; codeine and tramadol in children and breastfeeding (ultrarapid metabolizers).
* '''Black box warning:''' Addiction, abuse, and misuse; life-threatening respiratory depression; accidental exposure (especially transdermal and pediatric); neonatal opioid withdrawal syndrome; and fatal interaction with benzodiazepines and other central nervous system depressants and alcohol.
* '''Interactions:''' Benzodiazepines and CNS depressants and alcohol (respiratory depression), serotonergic drugs (serotonin syndrome with tramadol, tapentadol, meperidine, fentanyl), MAO inhibitors (meperidine), CYP3A4 interactions (fentanyl, oxycodone).
* '''Pregnancy / lactation:''' Use cautiously; risk of neonatal withdrawal.
* '''High-alert:''' Yes.

== Adverse effects ==
* '''Common side effects:''' Constipation (does not improve over time), sedation, nausea, pruritus, urinary retention, miosis.
* '''Serious effects to report:''' Respiratory depression (rate below 12), oversedation, hypotension, serotonin syndrome, withdrawal if stopped abruptly.
* '''Antidote / reversal:''' Naloxone.

== Nursing process ==
* '''Assessment before administration:''' Pain score, respiratory rate and sedation level, blood pressure, bowel pattern, opioid tolerance.
* '''Interventions during therapy:''' Assess respirations and sedation before and after dosing; hold and notify for slow breathing or deep sedation; start a bowel regimen; have naloxone available; independent double-check per policy.
* '''Monitor:''' Respiratory rate, sedation scale, pain relief, bowel function, blood pressure.
* '''Evaluation / expected outcome:''' Adequate pain control with safe respirations.

== Patient teaching ==
* '''Patient teaching:''' Take a stool softener and laxative; do not combine with alcohol or sedatives; do not drive until stable; store securely.
* '''Notify provider if:''' Slow or shallow breathing, extreme drowsiness, confusion, no bowel movement for several days.
* '''Administration tips:''' IV push slowly; verify fentanyl patch dose and opioid tolerance; never cut ER tablets.

[[Category:Opioid Analgesics]]

Opioids - Revision history

Docmoates: Add medication infobox (Drugbox) to monographs

Docmoates: NCLEX nursing pharmacology monographs — batch import