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Brunner 12
Exam 1
| Term | Definition |
|---|---|
| Acute Pain | Recent onset of pain that abates as healing occurs; serves as a warning signal that something is wrong or needs attention. |
| Addiction | A chronic neurologic and biologic disease characterized by behaviors that include one or more of the following; impaired control over drug use, compulsive use, continued use despite harm, and craving to use the opioid for effects other than pain relief. |
| Adjunct analgesic agent | a drug that has a primary indication other than pain (e.g., anticonvulsant, antidepressant, sodium channel blocker, or muscle relaxant) but is an analgesic agent for some painful conditions; sometimes referred to as coanalgesic |
| agonist-antagonist | a type of opioid (e.g., nalbuphine and butorphanol that binds to the kappa opioid receptor site acting as an agonist (capable of producing analgesia) and simultaneously to the mu opioid receptor site acting as an antagonist (reversing mu agonist effects) |
| Allodynia | pain due to a stimulus that does not normally provoke pain, such as touch; typically experienced in the skin around areas affected by nerve injury and commonly seen with many neuropathic pain syndromes |
| Antagonist | drug that competes with agonists for opioid receptor binding sites; can displace agonists, thereby inhibiting their action |
| Breakthrough Pain | A transitory increase in pain that occurs on a background of otherwise controlled persistent pain |
| Ceiling effect | an analgesic dose above which further dose increments produce no change in effect` |
| Central sensitization | a key central mechanism of neuropathic pain; the abnormal hyperexcitability of central neurons in the spinal cord, which results from complex changes induced by the incoming afferent barrages of nociceptors |
| Chronic or persistent pain | pain that may or may not be time limited but that persists beyond the usual course/time of tissue healing |
| Comfort-function goal | the pain rating identified by the individual patient above which the patient experiences interference with function and quality of life (e.g., activities the patient needs or wishes to perform) |
| Efficacy | the extent to which a drug or another treatment “works” and can produce the effect in question—analgesia in this context |
| half-life | he time it takes for the plasma concentration (amount of drug in the body) to be reduced by 50% |
| Hydrophilic | Readily absorbed in aqueous solution |
| Intraspinal | “within the spine”; refers to the spaces or potential spaces surrounding the spinal cord into which medications can be given; synonymous with neuraxial |
| Lipophilic | Readily absorbed in fatty tissues |
| Metabolite | The product of biochemical reactions during drug metabolism |
| Mu agonist | any opioid that binds to the mu opioid receptor subtype and produces analgesic effects (e.g., morphine); used interchangeably with the terms full agonist, pure agonist, and morphine like drug |
| Neuraxial | Of the central nervous system, synonymous with intraspinal |
| Neuropathic (pathophysiologic) pain | pain sustained by injury or dysfunction of the peripheral or central nervous systems and distinctly different from nociceptive (physiologic) pain |
| Neuroplasiticity | the ability of the peripheral and central nervous systems to change both structure and function as a result of noxious stimuli |
| Nociceptive (physiologic) pain | pain that is sustained by ongoing activation of the sensory system that conducts the perception of noxious stimuli; implies the existence of damage to somatic or visceral tissues sufficient to activate the nociceptive system |
| Nociceptor | type of primary afferent neuron that has the ability to respond to a noxious stimulus or to a stimulus that would be noxious if prolonged |
| Nonopioid | refers to analgesic agents that include acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs); term is used instead of “nonnarcotic” |
| NSAID | an acronym for nonsteroidal anti-inflammatory drug (pronounced “en said”); also referred to as aspirinlike drugs |
| opioid | refers to codeine, morphine, and other natural, semisynthetic, and synthetic drugs that relieve pain by binding to multiple types of opioid receptors; term is preferred to “narcotic” |
| opioid dose-sparing effect | occurs when a nonopioid or adjuvant is added to an opioid, allowing the opioid dose to be lowered without diminishing analgesic effects |
| Opioid induced hyperalgesia | phenomenon in which exposure to an opioid induces increased sensitivity, or a lowered threshold, to the neural activity conducting pain perception; it is the “flip side” of tolerance |
| Opioid Naive | denotes a person who has not recently taken enough opioid on a regular enough basis to become tolerant to the opioid’s effects |
| Opioid Tolerant | denotes a person who has taken opioids long enough at doses high enough to develop tolerance to many of the opioid’s effects, including analgesia and sedation |
| Peripheral sensitization | peripheral mechanism neuropathic pain that occurs when there are changes in the number and location of ion channels;sodium channels abn accumulate in injured nociceptors, producing lower nerve depol, ectopic discharges, increase in the response to stimuli |
| Physical dependence | the body’s normal response to administration of an opioid for 2 or more weeks; withdrawal symptoms may occur if an opioid is abruptly stopped or an antagonist is given |
| Placebo | any medication or procedure, including surgery, that produces an effect in a patient because of its implicit or explicit intent and not because of its specific physical or chemical properties |
| Preemptive analgesic agents | preinjury pain treatments (e.g., preoperative epidural analgesia and preincision local anesthetic infiltration) to prevent the establishment of peripheral and central sensitization of pain |
| refractory | nonresponsive or resistant to therapeutic interventions such as analgesic agents |
| self-report | the ability of an individual to give a report—in this case, of pain, especially intensity; the most essential component of pain assessment |
| TItration | upward or downward adjustment of the amount (dose) of an analgesic agent |
| Tolerance | a process characterized by decreasing effects of a drug at its previous dose, or the need for a higher dose of drug to maintain an effect |
| Withdrawal | result of abrupt cessation or rapid decrease in dose of a substance upon which one is physically dependent. It is not necessarily indicative of addiction |
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