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Chapter 18
Drugs for the control of pain
| Question | Answer |
|---|---|
| Define acute pain. | Intense pain over a brief time |
| What is chronic pain? | Longer lasting pain ( weeks, months, or years) |
| What is Nociceptor pain? | Injury to tissues |
| Define Somatic pain. | Sharp, localized sensation in the body |
| What is visceral pain? | Generalized, dull, internal throbbing/ aching pain |
| Define adjuvant analgesic. | Drugs not classified as analgesics (pain relievers) but can provide relief for specific pain to the patient |
| Carbamazepine is approved for treatment of trigeminal neuralgia, but can also be used for pain management. | An example of Adjuvant analgesic |
| What is an anesthetic blocking? | Another type of analgesic for pain managment |
| 5% lidocaine used for pain like sunburns,insect bites, and even post surgical pain. | An example of Anesthetic nerve blocking |
| What is an opioid? | Anything containing opium consists of 9-14% morphine and 0.8-2.5% codeine, these substances are called opiates. |
| Define narcotics. | Opioid drugs that cause sensitivity to pain and CNS depression (hallucinogens, heroin, amphetamines, and marijuana) |
| What is an opioid agonist? | Drugs that activate both mu and kappa receptors (analgesia, decreased GI motility, miosis, physical and respiratory dependence, sedation) |
| Define opioid antagonist. | Drugs that block mu and kappa receptors. |
| What is a mixed opioid agonist & antagonist? | Drugs that occupy one receptor and block the other |
| Aside pain management, opioids are used for other important effects like? | -Suppressing cough -Slowing motility of GI tract for cases with extreme diarrhea |
| Opioids have the potential to cause.. | Physical and psychological dependence |
| Name some drugs that are an opioid agonist. | Morphine (Astramorph PF, Duramorph) |
| What are adverse effects of opioid agonist? | Dysphoria, hallucinations, nausea, constipation, dizziness, itching sensation, respiratory depression, sedation, euphoria, physical and psychological dependence |
| What is a PCA pump? | This pump makes it possible for patients to self medicate with opioid medications by pressing a limited rate-controlled button. Safe levels of medication are delivered with an infusion pump. |
| What is the definition of an opioid antagonist? | Drugs that can compete with opioids for access to the opioid receptor, these drugs prevent effects of opioids agonists. |
| Used to reverse symptoms of opioid intoxication. | Opioid antagonist. |
| Name a few drugs that are opioid antagonist. | Naloxone, (Evzio, Narcan) |
| What are adverse effects of opioid antagonist? | Rapid loss of analgesia, increased BP, tremors, hyperventilation, nausea, vomiting and drowsiness |
| What is the treatment for opioid dependence? | Switch patient from IV to inhalation forms of illegal drugs to methadone. (methadone is an opioid, but it does not cause the same degree of euphoria) |
| Define methadone maintenance. | Methadone does not cure the patient's dependence, but it allows the patient to slowly withdraw from drug abuse without having severe symptoms. |
| What are NSAID's? | NSAID's inhibit pain mediators at nociceptor level. |
| What are a few examples of NSAID's? | Acetaminophen Ibuprofen Aspirin |
| NSAID's inhibit ____ which reduces _____? | COX, pain & inflammation |
| Define COX1. | The basis of NSAID therapy, no NSAID's can be just COX1. NSAID's can either be COX1 and COX2 or just COX 2 |
| Define COX2. | More specific and provides peripheral pain relief |
| What is a tension headache? | Muscles of the head and neck become very tight due to stress |
| Define Migraine. | Most painful type of headache characterized by throbbing or pulsing pain, sometimes preceded by an aura. They are also usually accompanied by nausea and vomiting |
| What is aura? | Sensory cues that let the patient know that a migraine attack is coming soon |
| Give an example of Aura. | |
| What are triggers for migraines? | Nitrates, MSG (found in most asian food), Red wine, perfumes, food additives, caffeine, chocolate, aspartame. |
| Tension headaches can be treated with OTC analgesics like... | Aspirin, Ibuprofen, Acetaminophen |
| What are 2 major drug classes for drug therapy for migraines? | Triptans, Ergot Alkaloids |
| Define Triptans. | Selective serotonin receptor agonists, meaning that they work by stimulating serotonin to reduce inflammation and constrict. |
| Define Ergot Alkaloids. | Works by narrowing the blood vessels around the brain. Ergotamine also affects blood flow patterns that are accosted with certain types of headaches -Category X |
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alyxinwndrland
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