The narcotic agonists–antagonists stimulate certain opioid receptors but block other such receptors. These drugs, which have less abuse potential than the pure narcotic agonists, exert a similar analgesic effect as morphine. Like morphine, they may cause sedation, respiratory depression, and constipation. They have also been associated with more psychotic-like reactions, and they may even induce a withdrawal syndrome in patients who have been taking narcotics for a long period.
Available narcotic agonists–antagonists include buprenorphine (Buprenex), butorphanol (generic), nalbuphine (generic), and pentazocine (Talwin).
可用的麻醉药品激动剂拮抗剂包括丁丙诺啡（Buprenex）、布托啡诺（通用名）、纳布啡（通用名）、喷他佐辛（Talwin）。
The narcotic agonists–antagonists act at specific opioid receptor sites in the CNS to produce analgesia, sedation, euphoria, and hallucinations. In addition, they block opioid receptors that may be stimulated by other narcotics. These drugs have three functions: (1) relief of moderate to severe pain, (2) adjuncts to general anesthesia, and (3) relief of pain during labor and delivery.
Narcotic agonists–antagonists are readily absorbed after IM administration and reach peak levels rapidly when given IV. They are metabolized in the liver and are excreted in the urine or feces. They are known to cross the placenta and enter breast milk.
Buprenorphine is available for use in IM, IV, oral, transdermal, and transmucosal forms. Butorphanol is available for IM or IV administration and as a nasal spray. Nalbuphine is administered parenterally (subcutaneous, IM, or IV). Pentazocine is available in parenteral and oral forms, making it the preferred drug for patients who will be switched from parenteral to oral forms after surgery or labor.
Narcotic agonists–antagonists are contraindicated in the presence of any known allergy to any narcotic agonist–antagonist to avoid hypersensitivity reactions.
麻醉药品激动剂拮抗药禁忌：已知对任何麻醉药品激动剂拮抗药过敏，以避免超敏反应。
Caution should be used in cases of physical dependence on a narcotic because a withdrawal syndrome may be precipitated; the narcotic antagonistic properties can block the analgesic effect and intensify the pain. Narcotic agonists–antagonists may be desirable for relieving chronic pain in patients who are susceptible to narcotic dependence, but extreme care must be used if patients are switched directly from a narcotic agonist to one of these drugs.
★Vocabulary ★
abuse – n. 滥用
induce – v. 诱导，引起
withdrawal syndrome – 戒断综合症
buprenorphine – n. 丁丙诺啡
Buprenex – n. 丁丙诺啡商标名
butorphanol – n. 布托啡诺
nalbuphine – n. 纳布啡
pentazocine – n. 喷他佐辛
Talwin – n. 喷他佐辛商标名
transdermal – a. 经皮的
transmucosal – a. 经粘膜的
1. When administering codeine, the nurse should be aware that:
A. Codeine produces more sedation than other opiates.
B. Codeine causes diarrhea, so the client must take an additional drug to prevent this.
C. Codeine is very constipating.
D. Codeine is an antitussive in high doses.
2. The nurse recognizes that the primary indication for the administration of morphine is to do what?
A. Relieve pain
B. Reduce anxiety
C. Treat left ventricular failure
D. Decrease level of consciousness
奥医教育“在线自测”正式上线，复习练习、效果检验，奥医NCLEX-RN/ISPN题库一站完成。
答案Answers 1. C. Codeine is very constipating. Rationale: Codeine is very constipating, so the client’s diet should include foods that fight constipation, such as water, fruits, and vegetables. 2. A. Relieve pain Rationale: The principal indication for morphine is relief of moderate to severe pain. The drug can relieve postoperative pain, the chronic pain of cancer, and pain associated with labor and delivery. In addition, morphine can be used to relieve pain of myocardial infarction and dyspnea associated with left ventricular failure and pulmonary edema. Morphine may also be administered before surgery for sedation and reduction of anxiety.
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