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Pain DPA
Duke PA pharmacology pain
| Question | Answer |
|---|---|
| Pain assessment includes 4 quality of life factors | physical, psychological, social, spiritual |
| 2 broad categories of pain | adaptive, maladaptive |
| Adapative pain | protect from further injury or promote healing |
| Maladaptive pain | pain as disease |
| 2 types of pain | nociceptive, neuropathic |
| nociceptive pain | acute pain |
| somatic pain | throbbing, squeezing, aching, stabbing |
| visceral | cramping, gnawing, boring - less well localized |
| nociceptors | free endings of primary afferent nerve fibers |
| transduction releases what? | sensitizing substances - ex. Prostaglandins, etc. |
| sensitizing local receptors causes which tissue reactions? | edema, vasodilation, inflammation |
| A-delta fibers transmit which pain? | sharp, well localized, high-intensity mechanical, some thermal |
| C fibers transmit which pain? | dull, aching, poorly localized pain, mechanical, thermal, chemical |
| modulation inhibits transmission of what? | noxious stimuli |
| Treatment for nociceptive pain includes which meds? | APAP, NSAIDS, Opiods, Adjuvants |
| Inflammatory pain responds to which meds? | NSAIDS, corticosteroids |
| Which type of pain results from damage to the nervous system? | neuropathic |
| Hyperalgesia | painful stimulus --> increased response |
| Allodynia | non-painful stimulus --> pain |
| Persistent pain | prolonged after transient stimulus |
| referred pain | spread of pain to uninjured tissue |
| Does neuropathic pain respond to NSAIDS? | NO |
| What can you treat neuropathic pain with? | antiepileptics, antidepresseants, local anesthetics, maybe opioids |
| What is somatoform pain disorder? | psychological - pain doesn't match symptoms |
| Treatment for psychogenic pain | adjuvant drugs,behavioral therapy |
| What is APAP? | acetaminophen |
| Does APAP have anti-inflammatory effect? | NO |
| Does APAP cause GI damage? | NO |
| Does APAP have anti-platelet activity? | NO |
| Is APAP and analagesic and ani-pyretic? | YES |
| What is ASA? | aspirin |
| what is ASA's MOA? | inhibits Cox-1 and Cox-2 |
| What are examples of non-salicylates? | Ibuprofen, Naproxen, etc. |
| What is Celebrex's MOA? | Cox-2 inhibitor |
| What is the risk of celebrex? | cardiovascular toxicity |
| What are the three opiod receptors? | mu, delta, kappa |
| What action do naloxone and naltrexone have? | antagonist - useful in overdoses |
| What action do most opioids have? | full agonists |
| What are the three classes of opioids? | morphine-like, meperidine-like, methadone-like |
| Full or weak agonist - morphine? | full |
| Full or weak agonist - fentanyl | full |
| full or weak agonist - hydromorphone | full |
| full or weak agonist - oxycodone | full |
| full or weak agonist - methadone | full |
| full or weak agonist - meperidine | full |
| full or weak agonist - codeine | weak |
| full or weak agonist - propoxyphene | weak |
| full or weak agonist - hydrocodone | weak |
| where do combination analgesics target? | multiple sites of action, so multiple pain pathways |
| What is "dose-sparing" | combination analgesics allow for lower doses of both drugs |
| Which combination analgesics have a ceiling effect? | only when adding to opioid |
| What are the 4 A's of opioids? | Analgesia, ADLs, Adverse reactions, Aberrant drug-taking behavior |
| What are examples of adjuvants? | Antidepressants, antiepileptic drugs, local anesthetics, topical agents, misc. |
Created by:
ges13
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