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Stack #152108
pharm ch 10, kilgore lvl1
| Question | Answer |
|---|---|
| analgesics | medications that relieve pain w/o causing a loss of consciousness, "pain killers" |
| pain | unpleasant sensory and emotional experience assoc. w/ actual or potential tissue damage |
| acute pain | -sudden onset -usually subsides once treated |
| Chronic pain | -persistent or recurring -lasts 6 wks or longer -often difficult to treat |
| Pain transmission Gate theory | most common theory that uses the analogy of a gate to describe how impulses from damaged tissues are sensed in the brain |
| bradykinin, histamine, potassium, prostaglandins, serotonin | substances released in the body due to tissue injury that start the pain process by stimulating nerve endings |
| A fibers | large myelinated nerve fibers with fast conduction that transmit sharp and well localized pain |
| C fibers | Small unmyelinated nerve fibers with slow conduction that transmit dull and nonlocalized pain |
| Doral horn | The "gate" that blocks pain impulses from the A and C fibers of tissue...if no impulses are transmitted to higher centers in the brain, there is no pain perception |
| activation of A fibers | closes gate and inhibits transmission of pain impulses to brain, so pain perception is limited |
| activation of C fibers | opens gate and allows transmission of pain impulses to brain, so pain perception is present |
| Enkephalins | endogenous neurotransmitters naturally produced as painkillers -bind to opioid receptors -inhibit transmission of pain by closing gate |
| Endorphins | endogenous neurotransmitters naturally produced as painkillers -bind to opioid receptors -inhibit transmission of pain by closing gate |
| rubbing/massaging injury | stimulates A fibers which close gate and recognition of pain reduced |
| "Breakthrough" pain | some pain is greater than the effects of the specific drug given and still can be felt by client |
| analgesic ceiling effect | when the highest safe dose of a given pain drug no longer effectively controls pain sensation |
| Opioid analgesics | -pain relievers that contain opium -narcotics: VERY strong pain relievers -includeds syntetic opioids |
| codeine sulfate | cough relief |
| Meperidine HCL (demerol) | -obstetris analgesia, preoperative sedation -restricted use due to AE of seizures |
| Methadone HCl (dolophine) | also used for opioid detoxification and opioid addiction maintenance |
| Morphine sulfate (astra/dura/infu/oramorph, roxalnol, etc..) | opium alkaloid |
| naloxone HCl (narcan) | -treatment of opioid overdose -postoperative anesthesia reversal |
| Agonist | -bind to opioid pain receptor in brain -cause reduction of pain sensation |
| partial agonists | -bind to pain receptor -cause weaker neurologic response than a full agonist (agonist-antagonists or mixed agonist) |
| Antagonists | - bind to a pain receptor and exert no response -reverse the effects of these drugs on pain receptors (competitive antagonist) |
| Mu | -type of opioid receptor -Morphine is prototypical agonist w/ the effects of supraspinal analgesia, resp depression, euphoria and sedation |
| Kappa | -type of opioid receptor -ketocyclazocine is prototypical agonist w/ the effects of spinal analgesia, sedation and miosis |
| adjuvant analgesic drugs | -nonopioid drug given with opioid drug -same level of pain relief w/ less narcotic administered to client -typically NSAIDs, antidepressans, anticonvulsants, or corticosteroids |
| cough center suppression, treatment of diarrhea, balance anesthesia | other uses of opioids |
| known drug allergy and elevated intracranial pressure | major contraindications for opioids |
| respiratory depression | major AE for opioids |
| naloxone (Narcan) | counteracts the effects of too much morphine. use slowly to avoid totally removing pain relief |
| naltrexone (Revia) | opioid addiction breaking aid -binds to opiate receptors and prevents a response -used for complete or partial reversal of opioid-induced respiratory depression |
| Opioid tolerance | same amount of drug no longer achieves desired effect (physiologic result of chronic opioid treatment) |
| psychologic dependence | pattern of compulsive drug use characterized by a continuued craving for an opioid, and the need to use the opioid for effects other than pain relief |
| physical dependence | physiologic adaptation of the body to the presence of an opioid -seen wehn the opioid is abruptly discontinued or when an opioid antagonist is administered |
| opioid tolerance and physical dependence vs psychologic dependence (addiction) | misunderstanding of these terms leads to ineffective pain management and contributes to the problem of under-treatment |
| opioid withdrawl/opioid abstinence syndrome | (detox) manifested as: anxiety, irritability, chills and hot flashes, joint pain, lacrimation, ehinorrhea, diaphoresis, nausea, vomiting, abdominal cramps, diarrhea, confusion |
| acetaminophen | -blocks pain impulses peripherally by inhibiting prostaglandin synthesis -lethal when overdosed, whether intentional or due to chronic unintentional misuse by causing hepatic necrosis -long-term ingestion of large doses also causes nephropathy |
| acetylcysteine regimen (bucomyst) | recommended antidote for acetaminophen overdose |
| withhold dose and contact physician when you observe | decline in patient's condition or if vital signs are abnormal, esp if respiratory rate is less than 12 breaths/min |
| morphine sulfate (astramorph, duramorph, infumorph, oramorph..others) | -natural alkaloid, drug prototype for opioid and narcotics -opioid analgesia -used for moderate to severe pain |
| naloxone HCL (Narcan) | -opioid antagonist -treatment of opioid overdose -postop anesthesia reversal |
| naltrexone HCl (trexan) | -maintenance of opioid-free state -opioid antagonist |
| codeine sulfate | -primarily used for cough relief -used for mild to moderate pain |
| fentanyl citrate (Duragesic, Oralet, Actiq) | -primarily used for procedural sedation or adjunct to gen anesthesia -oral/transdermal used for longer-term pain mgmt for malignant and nonmalignant chronic pain |
| acetaminophen (tylenol) | - Non-opioid analgesic - |
Created by:
gfcfnina
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