Drug Name Mechanism of Action Indication Side Effects Nursing Responsibilities

Generic Name: Methadone is a Relieve severe pain, Drowsiness, light- Before:

Methadone diphenyl-heptane detoxification and headedness,
derivative opioid agonist temporary dizziness, 1. Verify patient’s identity and physician’s order.
Brand Name: that primarily acts on the maintenance for hallucination, nausea, 2. Obtain history of hypersensitivity to the drug and history of d
Dolophine u-receptor. It inhibits the ambulatory patients vomiting, dry mouth, dependence.
ascending pain with narcotic constipation, 3. Assess patient’s level of pain.
Drug Classification: pathways, alters the abstinence transient 4. Obtain vital signs especially respiratory rate for baseline data.
Opioid Analgesic perception and response syndrome. hypotension, muscle 5. Perform hand hygiene.
to pain and causes pain, respiratory
Dosage: generalized CNS depression, During:
2.5 mg – 10 mg tablet, depression. orthostatic
10 mg/ml injection hypotension 1. Assist patient in comfortable position.
2. Monitor and observe patient during administration of
Route: Contraindication: medication.
PO, IM, IV Severe respiratory
depression, After:
Timing: bronchial asthma,
Q3-4h; q6-8h known or suspected 1. Monitor patient’s vital signs especially respiratory rate
GI obstruction, therapeutic effectiveness of the drug.
Pregnancy Category Risk: paralytic ileus, 2. Evaluate and educate patient for possible side and adverse effect
B (D for use of higher doses) increased the medication.
intracranial 3. Instruct patient to change position slowly.
pressure, head 4. Encourage patient to notify HCP for troublesome side or adve
injury, severe effects.
hepatic impairment 5. Perform hand hygiene.
6. Document the procedure,

Reference:
Lugo, R. A., Satterfield, K. L., & Kern, S. E. (2005).
Pharmacokinetics of methadone. Journal of Pain & Palliative

Care Pharmacotherapy, 19(4), 13-24.

Drug Name Mechanism of Indication Side Effects Nursing Responsibilities

Action
Generic Name: Morphine an opioid Symptomatic relief CNS depression, Before:
Morphine Sulfate analgesic a of severe acute and orthostatic
phenanthrene chronic pain after hypotension, 1. Verify patient’s identity and physician’s order.
Brand Name: derivative which acts nonnarcotic syncope, 2. Obtain history of hypersensitivity to the drug and history of d
Morin, MST Continus mainly on the CNS and analgesics failed and bradycardia, dependence.
smooth muscles. as preanesthetic double vision, 3. Assess patient’s level of pain.
Drug Classification: It binds to opiate medication dyspnea abdominal pain, 4. Obtain vital signs especially respiratory rate for baseline data.
Opioid Analgesic receptors in the CNS of acute left
nausea, vomiting, 5. Perform hand hygiene.
altering pain ventricular failuredry mouth,
Dosage: perception and and pulmonary diarrhea, dizziness, During:
10 mg – 30 mg sustained response by edema and pain of headache,
release capsules, modulating the MI. confusion, 1. Assist patient in comfortable position.
10 mg/ml – 25 mg/ml descending inhibitory dependence, 2. Monitor and observe patient during administration of the medication
injection pathway from the bladder spasm,
brain. Analgesia, Contraindication: dyspnea, After:
Route: euphoria and Hypersensitivity to respiratory
PO, IM, IV 1. Monitor patient’s vital signs especially respiratory rate and therape
dependence are opiates, respiratory depression.
effectiveness of the drug.
thought to be due to its depression,
Timing: 2. Evaluate and educate patient for possible side and adverse effects of
action at the u-1 obstructive airway
Q4h or prn for capsules, and receptors medication.
while disease, paralytic
as ordered for injection 3. Instruct patient to change position slowly.
inhibition are due to ileus, increased ICP,
4. Encourage patient to notify HCP for troublesome side or adverse effec
action at the u-2 GI obstruction, and
Pregnancy Category Risk: 5. Perform hand hygiene.
receptions. circulating shock.
B (D for use of higher doses) 6. Document the procedure,
Reference:
Rauck, R., Deer, T., Rosen, S., Padda, G., Barsa, J., Dunbar,
E., & Dwarakanath, G. (2010). Accuracy and efficacy of

intrathecal administration of morphine sulfate for treatment of

intractable pain using the Prometra® Programmable Pump. Neuromodulation: Technology at the Neural Interface, 13(2),

102-108.

Drug Name Mechanism of Indication Side Effects Nursing Responsibilities

Action
Generic Name: Fentanyl is an Short-acting CNS sedation, Before:
Fentanyl opioid analgesic analgesic during dizziness,
that predominantly operative and euphoria, 1. Verify patient’s identity and physician’s order.
Brand Name: interacts with u- perioperative diaphoresis, 2. Obtain history of hypersensitivity to the drug and history of d
Duragesic, Sublimaze receptors in the periods, delirium, dependence.
CNS. It increases supplemental in hypotension, 3. Assess patient’s level of pain.
Drug Classification: pain threshold, general and regional bradycardia, 4. Obtain vital signs especially respiratory rate for baseline data.
Opioid Analgesic alters pain anesthesia, patient blurred vision, 5. Perform hand hygiene.
perception, and undergoing open nausea, vomiting,
Dosage: inhibits the heart surgery as constipation, During:
0.05 mg/ml injection, 100 – ascending pain attenuation respiratory
200 mcg lozenges, 12 mcg/h pathways by response to surgical depression, urinary 1. Assist patient in comfortable position.
transdermal patch binding to stress. retention. 2. Monitor and observe patient during administration of the medication.
stereospecific
Route: receptors at Contraindication: After:
Buccal, Sublingual, IM, IV several sites within Patients who receive
1. Monitor patient’s vital signs especially respiratory rate and therape
the CNS. MAO inhibitors
Timing: effectiveness of the drug.
within 14 days,
30-60 minutes pre-surgery 2. Evaluate and educate patient for possible side and adverse effects of
myasthenia gravis,
q2-4h, as ordered medication.
respiratory
3. Instruct patient to change position slowly.
depression, GI
Pregnancy Category Risk: 4. Encourage patient to notify HCP for troublesome side or adverse effects.
obstruction,
C 5. Perform hand hygiene.
recurrent episode of
6. Document the procedure,
 epistaxis
Reference:

Armenian, P., Vo, K. T., Barr-Walker, J., & Lynch, K. L. (2018).

Fentanyl, fentanyl analogs and novel synthetic opioids: a

comprehensive review. Neuropharmacology, 134, 121-132.