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Chapter 18

Drugs for the control of pain

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
Created by: alyxinwndrland