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Ch. 11 Pharm

what do analgesics do relieve pain w/o causing loss of consciousness
name some analgesics painkillers, opioids, NSAIDs
Pain is: pt oriented, tissue damage, personal
what are nociceptors sensory nerve fibers that cause pain and transmit from body to spinal cord and brain
What are the four processes of nociception 1. stimuli- transduction to cord 2. transmission- to brain 3. perception of pain 4. modulation- neurotransmitters block pain impulse
what is a pain threshold level of stimulus needed to produce the perception of pain, physiologic response of nervous system. "Tough cat, eat pain for brfst"
what is pain tolerance amt of pain can endure w/o interfering with normal fx, subjective response, psychologic
Classifications of pain in terms of onset and duration Acute- sudden, subsides Chronic- persistent, recurring, lasts 3-6mos
Pain classifications on source somatic- origin skeletal muscles, ligaments, joints
Visceral pain origin organs, smooth muscles, superficial
superficial pain skin, mucous membranes
deep pain tissues below skin level
vascular pain vascular/perivascular tissues, migraines
referred pain choecystitis, referred to back and scapular areas; heart attack
neuropathic pain nerve, CNS
phantom pain in area of body that's been removed, amputation
Cancer pain acute/chronic/both, from tumor pressure on nerves,organ, tissues
central pain tumor, trauma, disease affecting CNS tissues
which part of spinal cord is the "gate" located dorsal horn
What two fibers operate in the gate theory A(abstain) lg, fast fibers- close gate, limit perception of pain, C(carries)- sm, slow fibers- open gate to pain perception
what are the endogenous neurotransmitters that are our painkillers enkephalins, endorphins, bind to opioiod receptors, close gate
What is the gate theory impulses from damaged tissues are sensed in the brain are opened or closed by a "gate"
What are some of the substances released with tissue injury to start the pain process bradykinin, histamine, K, prostaglandins, serotonin Massage also closes gate
What is PCA by proxy someone else pushes PCA pump
what is opioid tolerance how much drug is needed to make comfortable
what is breakthrough pain pain b/n doses of pain meds
What do adjuvant drugs do with opioids assist primary drugs in relieving pain NSAIDs, antidepressants, anticonvulsants, corticosteroids
one common use of adjuvant is neuropathic pain, give two examples Amitriptyline(antidepressant) Gabapentin or pregabalin (anticonvulsants)
What are three classifications of opioids aganists, partial agonists, antagonist
Which two drugs are associated with the opioid ceiling effect pentazocine, nalbuphine b/c drug reaches max effect and higher dose does not x effect
What does an agonist do bind to opioid pain receptor in brain and causes analgesic response
what does a partial agonist do binds to pain receptor but causes weaker response
what are the 5 types of opioid receptors Mu, kappa, sigma, delta, epsilon, with mu, kappa, delta most responsive and mu most important for morphine sulphate
know 8 common opioids codeine sulfate, meperidine HCI(Demerol), methadone HCI(Dolophine), morphine sulfate, propoxyphene HCI, hydromorphone, oxycodone(percoset), fentanyl---set= Tylenol
Opioids main use alleviate moderate to severe pain, with adjuvants
what other uses for opioids cough suppressant, diarrhea, balanced anesthesia
what are contraindications of opioids resp depression, drug allergy Use caution if incr cranial press., obese, sleep apnea, paralytic ileus
adverse effects of analgesics euphoria, CNS depression, N/V, constipation, urinary retention, diaphoresis/flushing, miosis, itching
what is opioid tolerance need lgr dose to maintain same level, not addiction
Opioid psychological dependence is compulsive drug use other than for pain, continued craving
what is used for opioid overdose naloxone(Narcan), naltrexone(Revia) Given when resp depression occurs with opioid
What are nonopioid analgesics acetominophen, mild to moderate pain, analgesic and antipyretic effect, no anti-inflammatory effects
Mechanism of action for nonopioids similar to salicylates(aspirin)
what is antidote for overdose acetylcysteine regimen
what is maximum daily dose of nonopioids 4000 mg/day, 2000 mg for elderly
what are herbal analgesics Feverfew, from marigold, antiinflammatory
With opioid analgesics, what if decline in pt withhold and call Dr if resp is <10-12, watch for hypotension
Created by: palmerag



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