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NCTC Pharm Unit 1
| Question | Answer |
|---|---|
| Pain | Unpleasant sensory and emotional experience associated with actual or potential tissue damage |
| Pain threshold | the level of stimulus needed to produce painful sensation |
| Pain tolerance | the amount of pain a patient can endure without its interfering with normal function |
| Acute pain | sudden onset, sharp and localized, has physiologic response, and usually subsides |
| Chronic pain | slow onset, long duration (6 weeks or longer), dull, persistent aching that and |
| Somatic pain | originates from skeletal muscles, ligaments, or joints |
| Visceral pain | originates from organs and smooth muscles |
| Superficial pain | originates from skin or mucous membranes |
| Vascular pain | originates in vasculature as in migraines |
| Referred pain | originates in organs and is felt in other area |
| Neuropathic pain | results from injury to peripheral nerves and is often present in the absence of disease or pathology |
| Phantom pain | occurs in a body part that has been amputated |
| Cancer pain | has many causes: hypoxia, pressure, metastasis, pathologic fractures, muscle spasms, side effects of radiation, surgery, chemotherapy |
| Psychogenic pain | pain not related to physical conditions or disorders |
| Central pain | results from any condition that yields CNS damage |
| Gate theory of pain and pain relie | The gates regulate the flow of sensory impulses |
| endogenous neurotransmitters | Natural pain killers in the body |
| Enkephalins and endorphins | Are capable of binding with opioid receptors to inhibit pain transmission by closing the gate |
| Massage | stimulates large-diameter A-fibers to close the gate |
| holistic approaches: | transcutaneous electric nerve stimulation (TENS), massage, biofeedback, relaxation therapy, psychologic counseling |
| “breakthrough” pain | If taking long-acting meds, “breakthrough” pain needs treatment with short-acting forms |
| Meperidine (Demerol) | not recommended for long-term use due to accumulation of harmful metabolite |
| “ceiling effect” | the drug produces a maximal analgesic effect, and even if the dosage were increased, no further pain relief could be experienced |
| 3-step analgesic ladder | o Non-opioids +/- adjuvant meds o Opioids +/- non-opioids, +/- adjuvant meds o Opioids for moderate or sever pain +/- non-opioids, +/- adjuvant meds |
| OPIOID DRUGS | Relief of moderate to severe pain Provides balanced anesthesia (used in combination with anesthesia agents) Cough suppression Treatment of diarrhea |
| OPIOID DRUGS | Most serious side effect is respiratory depression` |
| what is the reversal agent for opiates | Naloxone hydrochloride (Narcan)- |
| What are things that are going to be taught for a patient going home on opioids for pain management | GI effects are common (N/V and constipation are most common) |
| What is drug tolerance - and why would you get it? | Opioid-tolerant – has received opioid drugs for log times and more likely to require higher dosages o Is at greater risk for opioid withdrawal syndrome upon discontinuation |
| Opioid tolerance | long-term exposure leads to diminution of the drug’s effects Leads to higher doses to maintain the same analgesic effect Can result in “medical addiction” |
| what happens when you take an overdose of Tylenol | Ingestion of large amounts can cause hepatic necrosis in acute overdose Long-term overuse is more likely to cause nephropathy |
| What is the antidote and treatment for a Tylenol overdose? | Antidote is acetylcysteine 140 mg/kg followed by 70 mg/kg q4h X 17 doses All 17 doses must be given to prevent hepatotoxicity, regardless of subsequent acetaminophen serum levels |
| GENERAL ANESTHETICS | Produce unconsciousness and skeletal muscle relaxation for surgical procedures |
| Regional ANESTHETICS | Regional anesthesia accomplished by blocking nerve conduction in areas where they are applied without causing loss of consciousness |
| Topical anesthetics | Applied directly to the skin and mucous membranes Available in creams, solutions, powders, gels, ointments, drops, and suppositories |
| Parenteral anesthetics | Administered by injection into the CNS or to areas adjacent to main nerves |
Created by:
kcorkinsnctc
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