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Pain DPA

Duke PA pharmacology pain

QuestionAnswer
Pain assessment includes 4 quality of life factors physical, psychological, social, spiritual
2 broad categories of pain adaptive, maladaptive
Adapative pain protect from further injury or promote healing
Maladaptive pain pain as disease
2 types of pain nociceptive, neuropathic
nociceptive pain acute pain
somatic pain throbbing, squeezing, aching, stabbing
visceral cramping, gnawing, boring - less well localized
nociceptors free endings of primary afferent nerve fibers
transduction releases what? sensitizing substances - ex. Prostaglandins, etc.
sensitizing local receptors causes which tissue reactions? edema, vasodilation, inflammation
A-delta fibers transmit which pain? sharp, well localized, high-intensity mechanical, some thermal
C fibers transmit which pain? dull, aching, poorly localized pain, mechanical, thermal, chemical
modulation inhibits transmission of what? noxious stimuli
Treatment for nociceptive pain includes which meds? APAP, NSAIDS, Opiods, Adjuvants
Inflammatory pain responds to which meds? NSAIDS, corticosteroids
Which type of pain results from damage to the nervous system? neuropathic
Hyperalgesia painful stimulus --> increased response
Allodynia non-painful stimulus --> pain
Persistent pain prolonged after transient stimulus
referred pain spread of pain to uninjured tissue
Does neuropathic pain respond to NSAIDS? NO
What can you treat neuropathic pain with? antiepileptics, antidepresseants, local anesthetics, maybe opioids
What is somatoform pain disorder? psychological - pain doesn't match symptoms
Treatment for psychogenic pain adjuvant drugs,behavioral therapy
What is APAP? acetaminophen
Does APAP have anti-inflammatory effect? NO
Does APAP cause GI damage? NO
Does APAP have anti-platelet activity? NO
Is APAP and analagesic and ani-pyretic? YES
What is ASA? aspirin
what is ASA's MOA? inhibits Cox-1 and Cox-2
What are examples of non-salicylates? Ibuprofen, Naproxen, etc.
What is Celebrex's MOA? Cox-2 inhibitor
What is the risk of celebrex? cardiovascular toxicity
What are the three opiod receptors? mu, delta, kappa
What action do naloxone and naltrexone have? antagonist - useful in overdoses
What action do most opioids have? full agonists
What are the three classes of opioids? morphine-like, meperidine-like, methadone-like
Full or weak agonist - morphine? full
Full or weak agonist - fentanyl full
full or weak agonist - hydromorphone full
full or weak agonist - oxycodone full
full or weak agonist - methadone full
full or weak agonist - meperidine full
full or weak agonist - codeine weak
full or weak agonist - propoxyphene weak
full or weak agonist - hydrocodone weak
where do combination analgesics target? multiple sites of action, so multiple pain pathways
What is "dose-sparing" combination analgesics allow for lower doses of both drugs
Which combination analgesics have a ceiling effect? only when adding to opioid
What are the 4 A's of opioids? Analgesia, ADLs, Adverse reactions, Aberrant drug-taking behavior
What are examples of adjuvants? Antidepressants, antiepileptic drugs, local anesthetics, topical agents, misc.
Created by: ges13
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