Opioids

• Don’t combine benzodiazepines and opioids. If you need to reverse, use flumazenil.
• Central loci of opioid action (descending inhibitory pain pathways)
  • PAG
  • Nucleus Raphe magnus
  • Rostral ventromedial medulla

Short-Acting

• Oxycodone, Hydromorphone, Morphine
• Morphine can cause rash/pruritis

Long-Acting

• Oxycodone ER = OxyContin
• Methadone
• Fentanyl is really only used intra-op or in palliative care.