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Pharmacology
Pain Management
| Question | Answer |
|---|---|
| Pain involves both_______ and _______ components? | physical, psychological |
| 5th vital sign? | Pain |
| Recent-onset pain with generalized hyperactivity of the sympathetic nervous system | Acute Pain |
| Usually has an identifiable, precipitating cause? | Acute Pain |
| Pain that persists for at least three months beyond the usual course of an acute illness or injury? | Chronic Pain |
| Types of pain receptors? | mechanical, thermal, chemical |
| Electrophysiologic events at level of neuron for sensation and differentiation of various types of pain? | Nociception |
| Noxious stimuli translated into electrical activity at nerve endings? | Transduction |
| Nociceptive impulses carried to CNS? | Transmission |
| Small, myelinated and rapid transmission? | A-Delta Fibers |
| Good localization in conjunction with tactile receptors? | A-Delta Fibers |
| Very small, nonmyelinated and slower transmission? | C Fibers |
| Poor localization, associated with chronic and neuropathic pain? | C Fibers |
| Include some nociceptors: fast pain (sharp), thermoreceptors (cold) and mechanoreceptors (some touch)? | A-Delta Fibers |
| Include most nociceptors: slow pain (dull, ache) thermoreceptors (heat), itch receptors? | C Fibers |
| Patients with chronic pain often have low levels of? | Serotonin |
| Affects more than 1/3 of the US population? | Chronic Pain |
| Most common syndrome of Chronic WIdespread Pain (CWP)? | Fibromyalgia |
| Highest risk of fibromyalgia? | Females, 60-79 y/o |
| Chronic Pain Malignancy includes...? | Cancer, AIDS, ALS, MS, Sickle-cell, End-stage organ failure |
| Chronic Pain Non-malignancy includes...? | Osteoarthritis, "back" pain, Neuropathic pain, Fibromyalgia, Sympathetic reflex dystrophy, post-op post-traumatic pain |
| Painful response to a stimulus usually not painful? | Allodynia |
| Increased pain from a painful stimulus? | Hyperalgesia |
| Disturbance in way that CNS handles, transmits, and processes pain? | Central Sensitization |
| Signs and symptoms of chronic pain? | Disturbed sleep, poor appetite/nutrition, medication dependence |
| Four A's of pain treatment outcomes...? | Analgesia, ADL's, Adverse effects, Aberrant drug-taking behavior |
| Well localized, aching, throbbing, sharp, or pressure like pain is most likely? | Somatic nociceptive pain |
| Diffuse, squeezing, cramping, or gnawing is usually? | Visceral Nociceptive |
| Burning, tinging, shooting or shock like is? | Neuropathic pain |
| WHO Analgesic Ladder is? | Three step ladder |
| Step One of WHO Analgesic Ladder? | use of nonopioid analgesics (1-3) |
| Step Two of WHO Analgesic Ladder? | low dose opioid (4-6) |
| Step Three of WHO Analgesic Ladder? | Opioids for severe pain, high doses (7-10) |