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Analgesics 411
Pain
| Question | Answer |
|---|---|
| Disturbance of function or pathological change in a nerve | Neuropathy |
| Least stimulus intensity at which a subject perceives pain | Pain Threshold |
| Requiring more analgesia for the same level of pain | Pain tolerance |
| Tissue damaging stimulus | Noxious stimulus |
| Transient (< 3 months) | Acute Pain |
| An event that has a beginning and an end | Acute Pain |
| Well-defined | Acute Pain |
| Temporal onset | Acute Pain |
| Serves biological function | Acute pain |
| Usually supportive physical findings | Acute pain |
| Persistent (> 3 months) | Chronic Pain |
| Impossible to predict end | Chronic Pain |
| Lacks meaning | Chronic Pain |
| No biological function | Chronic Pain |
| Physical findings inconclusive | Chronic Pain |
| Peripheral neuropathy-long term nerve damage | Chronic Pain |
| Usually acute, response to analgesics usually good | Nociceptive Pain |
| Direct stimulation of pain fibers | Somatic Pain |
| Dull, aching, throbbing pain | Somatic Pain |
| Direct stimulation of pain fibers in internal organs, often poorly localized | Visceral Pain |
| Deep, aching, squeezing pain | Visceral Pain |
| Chronic, response to analgesics usually poor, may respond to aduvants | Neuropathic pain |
| Burning, shooting, tingling pain | Neuropathic pain |
| Aim-Pain relief | Acute Pain |
| Sedation often desirable | Acute Pain |
| Duration 2-4 hrs | Acute Pain |
| Regular and PRN Interval | Acute Pain |
| Standardized dose | Acute Pain |
| Parenteral Route | Acute pain |
| Use of adjuvants uncommon | Acute pain |
| Aim-pain prevention | Chronic Pain |
| Sedation usually undesirable | Chronic Pain |
| Duration-as long as possible | Chronic Pain |
| Regular (anticipatory) interval | Chronic Pain |
| Individualized dose | Chronic Pain |
| Oral Route | Chronic Pain |
| Use of adjuvants common | Chronic Pain |
| Drugs w/ ceiling effect | NSAIDs, ASA, APAP |
| Analgesic and antipyretic activity | APAP |
| Analgesic, antipyretic, anti-inflammatory activity | NSAIDs |
| Analgesic, antipyretic, anti-inflammatory, and antiplatelet activity | ASA |
| Avoid aspirin in: | Childres w/ viral syndromes, may precipitate Reye's syndrome |
| NSAIDs also available parenteral | Ketorolac, Indomethocin |
| Decreased ulcer incidence in high-risk pts | COX-2 Inhibitors |
| Opioids most dangerous/common ADRs | Respiratory depression, Constipation |
| Morphine and its cogeners | Codeine, hydrocodone, hydromorphone, levorphanol, oxycodone |
| Meperidine and its cogener | Fentanyl |
| Other opiate | Methadone |
| Active metabolite can accumulate and cause agitation and seizures | Meperidine |
| More potent, shorter acting, large rapid injection, can cause rigid chest syndrome | Fentanyl |
| Narcotic maintenance programs, chronic pain, not for acute pain, delayed onset and long duration | Methadone |
| MOA same as opiates, lower abuse potential | Partial agonists |
| Ceiling effect on analgesia and respiratory depression, may precipitate w/drawal in dependent pts, increase myocardial workload | Partial agonists |
| Binds but doesn't stimulate opiate receptors. Competes with opiates. Short acting, parenteral only | Naloxone (Narcan) |
| Long term use in formerly dependent pts, oral only | Naltrexone |
| Both reversal and long term use, parenteral only (2 strengths) | Nalmefene |
| Tinnitus, GI upset, hypersensitivity | ASA ADRs |
| GI distress, renal insufficiency | NSAIDs ADRs |
| Increased risk of serious CV thrombotic effects | COX-2 Inhibitors |
Created by:
lbreimeir
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