To alleviate moderate to severe pain, doctors often prescribe opioid analgesics. They dull pain sensations by interacting with certain receptors in the central nervous system. Constipation and slowed breathing are just two of the negative side effects of these substances.
The mnemonic “OPIOIDS” is helpful for students of medicine and nursing who need to remember important facts regarding opioid analgesics. The mnemonic device uses the word’s constituent parts as a cue for retaining key information about the medication class.
Students can use the mnemonic to learn and recall important information about opioid drugs like oxycodone and fentanyl (the “O” and “F” in OPIOIDS). It can also be used to help them remember crucial safety measures to take when delivering these drugs, such as checking for signs of respiratory depression (the “I” for “interventions” and “D” for “depression”).
In sum, the mnemonic can serve as a beneficial memory aid for students learning about opioid analgesics, especially during stressful conditions like exams or clinical rotations.
Role Of Opioids In Pain :
O – Opioids are the most potent pain-relieving drugs
P – Provide the most reliable and effective treatment for rapid pain relief
I – Inhibit pain-transmission neurons and activate pain-inhibitory neurons in the CNS
O – Opioid-related side effects can be reversed rapidly with the narcotic antagonist naloxone
I – Individuals fear opioid addiction, but the risk remains small for appropriate medical use
D – Dose escalation increases the risk of addiction
S – Side effects include nausea, vomiting, pruritus, sedation, and constipation
Key Points To Remember Regarding Opioid Analgesic Usage In Pain :
RAPID RELIEF: The most rapid pain relief is obtained by intravenous administration of opioids; relief with oral administration is significantly slower.
RESPIRATORY DEPRESSION: Because of the potential for respiratory depression, patients with any form of respiratory compromise must be kept under close observation following opioid administration; an oxygen-saturation monitor may be useful, but only in a setting where the monitor is under constant surveillance.
REDUCED RESPIRATION: Opioid-induced respiratory depression is primarily manifest as a reduction in respiratory rate and is typically accompanied by sedation. A fall in oxygen saturation represents a critical level of respiratory depression and the need for immediate intervention to prevent life-threatening hypoxemia.
MONITORING: Newer monitoring devices that incorporate capnography or pharyngeal air flow can detect apnea at the point of onset and should be used in hospitalized patients. Ventilatory assistance should be maintained until the opioid-induced respiratory depression has resolved.
NALOXONE: The opioid antagonist naloxone should be readily available whenever opioids are used at high doses or in patients with compromised pulmonary function.
DOSE VARIABILITY: Opioid effects are dose-related, and there is great variability among patients in the doses that relieve pain and produce side effects. Synergistic respiratory depression is common when opioids are administered with other CNS depressants.
INITIATION AND DOSING: Because of this variability in patient response, initiation of therapy requires titration to optimal dose and interval. The most important principle is to provide adequate pain relief. This requires determining whether the drug has adequately relieved the pain and timely reassessment to determine the optimal interval for dosing.
PCA: A now standard approach to the problem of achieving adequate pain relief is the use of patient-controlled analgesia (PCA). PCA uses a microprocessor-controlled infusion device that can deliver a baseline continuous dose of an opioid drug as well as preprogrammed additional doses whenever the patient pushes a button.
SPINAL ADMINISTRATION: The availability of new routes of administration has extended the usefulness of opioid analgesics. Most important is the availability of spinal administration. Opioids can be infused through a spinal catheter placed either intrathecally or epidurally. By applying opioids directly to the spinal or epidural space adjacent to the spinal cord, regional analgesia can be obtained using relatively low total doses.
Mnemonic: “RRR MND IPS“
(Rapid Relief, Respiratory Depression, Reduced Respiration, Monitoring, Naloxone, Dose Variability, Initiation and Dosing, PCA, Spinal Administration)