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pain management

pharm final

components of CNS brain and spinal cord
components of PNS connecting CNS to muscles and organs
What is the last system to develop in the fetus nervous system
3 kinds of neurons connecting CNS to body motor, sensory, interneurons
motor neurons aka: efferent
sensory neurons aka: afferent
major division of nervous system central vs. peripheral
efferent neurons impulses AWAY from CNS to muscles and organs
afferent neurons impulses TOWARD CNS from muscles and organs
interneurons connections within CNS
function of nervous system fetus is born with reflexes
basic functional unit to conduct an impulse neuron
cells which protect, support, and nourish neuron glia
receive impulses from the cell dendrites
carry impulses away from the cell axon
space or gap between neurons synapse
located at the end of the nerve brancehs and extend into the synapses located between neurons vesicles
neurons protected by myelin sheath and together form the fiber nerve fiber
fluid filled synapses contain neurotransmitters
role of presynaptic neurons send info
role of postsynaptic neurons receive info
What happens at the vesicles of the neuron where chemicals are synthesized, stored, and released
5 quick acting neurotransmitters acetylcholine, dopamine, norepinephrine, serotonin, GABA
2 slow acting neurotransmitters adrenocorticotropic hormone; antidiuretic hormone
sensation that occurs when peripheral tissue injury occurs and pain receptors are activated pain
order of transmission of pain signal spinal column, medulla oblongata, pons, hypothalamus, thalamus, cerebral cortex
What area in the brain is known as the relay station thalamus
Where is the pain sensation perceived cerebral cortex
what is substance P and where is it located located in nerve cells; serves as mediator in the transmission of painful stimuli
7 locations of pain receptors skin; underlying soft tissue; muscle fascia; joint surfaces; arterial walls; periosteum; scarce in most internal organs
examples of physical tissue damage heat, cold, pressure, stretch, spasm, ischemia
examples of chemical tissue damage substances released from injured cells and from inflammation
one of the strongest pain producing substances but quickly metabolized, associated with acute pain bradykinin
increase pain provoking effects of bradykinin by increasing pain receptor sensitivity prostaglandin
somatic pain localized sharp, burning, aching, gnawing, throbbing, and cramping; acute or chronic; constant or intermittent
visceral pain abdominal or thoracic organs, deep, dull and aching; cramping intermittent (spasms)
neuropathic pain injury of peripheral pain receptors, shooting, burning, stabbing
define acute and give adjectives of acute pain sharp, lancing, or cutting, sudden onset
define chronic and give adjectives of chronic pain lasting 3 months or more, slow pain, burning, aching or throbbing
types of analgesics opioid analgesics, non-opioid analgesics
opioid analgesic relieve what type of pain moderate to severe
Action of opioid analgesics inhibits transmission of pain impulses to the brain
Therapeutic effects of opioid analgesics reduces pain perception, promotes sedation and reduces emotional upsets
what type of drugs are opioid analgesics (schedule) schedule II - lead to drug abuse ad dependence and increased tolerance
routes of opioid analgesics PO, IM, subcutaneous, IV
Where are opioid analgesics metabolized liver
What route of opioid analgesics requires higher doses to obtain the desired therapeutic effects po
analgesic pharmacologic effects pain relief
CNS depression pharamcologic effects mild, moderate, sever (HR, RR, LOC)
GI motility pharmacologic effects constipation, smooth muscle spasms
indiciations for opioid analgesics acute pain; surgery; invasive procedures; L/D; GI disorders; pulmonary edema; cough (Codeine)
why called opioid agonists/ antagonists agents have agonistic activity at some receptor sites and antagonistic activity at others
antagonistic qualities of opioid agonists/ antagonisits produce withdrawal symptoms in people with opiate dependence, anecdote with overdose; less risk for abuse
why are opioid antagonists antidotes reverse or block analgesia, CNS respiratory depression and other effects
Action of opioid antagonists interfere with opioid binding with the opioid receptor sites (neutralizes)
What is the oldest drug of choice to reverse respiratory depression Naloxone (Narcan)
How long does it take Narcan to work minutes
routes of Narcan IV, IM, subcutaenous
Why would you need several doses of Narcan has short duration
what medication causes a depletion of substance P in nerve cells capsiacin (Zostrix)
capsiacin (Zostrix) routes topical
types of pain that can be treated by capsiacin (Zostrix) osteoarthritis; rheumatoid arthritis, postherpetic neuralgia, herpes zoster, diabetic neuropath, post-surgical pain
How should you titrate analgesics maximal effectiveness and minimal toxicity and avoid dependence
desired secondary opioid affects morphine may reduce pulmonary edema; depress cough reflex
undesirable secondary opioid affects constipation; respiratory depression; orthostatic hypotension; nausea/vomiting
What drug reduces excessive pain stimulation and is used when withdrawing from opioids clonidine
3 types of nonopioid drugs analgesics, antipyretics, antiinflammatories
nonopioid drugs defined drugs that relieve pain, fever, and inflammation
When does pain occur with tissue injury and inflammation
define fever elevation of temperature
what controlls temperature regulatory center - hypothalamus
define inflammation response to tissue damage
nonopioids used a prophylactic to prevent MI/Stroke acetaminophen and aspirin
what nonopioid drugs can cause renal impairment acetaminophen, aspirin, NSAIDs
what nonopioid has a metabolite that destroys liver cells and can cause hepatic impairment acetaminophen
what value does fever have bodies way of fighting infection
how long before surgery should you avoid durgs that impact platelet aggregation at least 2 weeks before and after
you must support adequate fluid intake with all nonopioid analgesics except acetaminophen
another name for acetaminophen tylenol
Why should you give next dose of analgesic before pain is severe need less drug and achieve greater effectivness
Created by: 1818554924