Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Pain Mgmnt
Pharmacotherapy II
| Question | Answer |
|---|---|
| Unpleasant sensory and emotional experience associated w/ actual or potential tissue damage or describe in terms of such damage | Acute pain |
| Pain that persists beyond the timie of expected healing | Chronic Pain |
| Pain related to tumor recurrence or tx | Cancer Pain |
| 3 kinds of endogenous endorphins | enkephalins, dynorphins, B-endorphins |
| Pain is modulated by | the endogenous opiate system in the brain |
| Pain that cannot be understood or described | neuropathic, phantom limb, sympathetically maintained, pain w/o nociception |
| 4 predictors of inadequate pain management | age, non-caucasion, low cognitive performance, multiple other medications |
| PQRST | Characteristics of pain P: palliative,provocative, quality, radiation, severity, temporal factors:intensity change |
| How do we measure pain | self report 0-10, physiological, and behavioral signs |
| Physiological signs of pain | HR, BP, RR, diaphoresis |
| Can we rely on physiological signs of pain | no, only as adjuncts, usually not reliable w/ chronic pain |
| Behavioral signs of pain | cry characteristics, facial expression, objective pain scale |
| Chronic pain depends on what? | self report only |
| Nonpharmacologic therapy | stimulation therapy, psychological intervention |
| TENS | Stimulation therapy: transcutaneous electrical nerve stimulation |
| Physiological intervention techniques of pain | informed post procedures, relaxation techinques, controlled attention, hypnosis, biofeedback |
| Opioids stimulate what receptors | U, K,S mu, kappa, delta |
| Most common AE’s of opioids | drowsiness, N/V, constipation, pruritis |
| What do we do if our pt starts withdrawing from opioids while tapering | go back to last dose w/o sxs and taper more slowly |
| Maximal biological response through binding to the opioid u-recptor | agonist |
| Submaximal response at the receptor even at high doses | partial agonists |
| Divergent activities at different receptors eg, analgesia ceiling, | agonist/antagonist |
| Benefits of ag/antagonist opioids | ceiling effect on resp depress, lower abuse potential, can precipitate w/d sxs w/ pt’s on full agonists |
| Reverse or inhibit the effects of agonists by preventing receptor access | antagonists |
| Antidote for opiods od | antagonists |
| Three adjuvant analgesics | caffeine, hydroxyzine, corticosteroids |
| May enhance analgesic effect of APA, ASA or ibuprofen | caffeine |
| May add to analgesic effect of opiods in postop and cancer pain while reducing N/V | Hydroxyzine |
| Can produce analgesia in pts w/ inflammatory dz’s or tumor infiltration of nerves | corticosteroids |
| 4 types of persistant pain | chronic nonmalignant pain (injury), nerupathic pain, functional pain: unidentifiable cause, cancer pain: chronic malignant pain |
| Tx goals for persistent pain | ↑tolerance for PA, ↓suffering, reliance on health care, medications, return to work, develop self-managing strategies |
| Three main agonists for moderate pain that are related to morphine both generic and trade names | codeine/APAP: tylonol #3, hydrocodone/APAP: Vicodin, Oxycodone/APAP: Percocet |
| Which agonists has a black box warning d/t CYP3A4 substrate | Oxycodone |
| Which drug has a metabolite that is a direct CNS irritant? Causes? | Meperidine: Demerol, Seizures |
| Name three opioid agonists that are for moderate pain unlike morphine | Meperidine, Tramadol, Tapentadol |
| What is the Gold std for potent opioids | Morphine: MS contin, Embeda |
| What can we give prior to morphine to prevent gastritis | antihistamine, d/t morphine histamine release |
| Name four opioid agonists related to morphine for severe pain | morphine, hydromorphone, levorphanol, oxymorphone |
| Two opioid agonists unrelated to morphine for severe pain | fentanyl, methadone |
| Which drug is good for chronic use? Other benefits? | Methadone, good for weaning other narcotics off |
| Which drug comes in oral (lollipop form) used for? | Fentanyl, good for cancer pain, Patch for chronic pain only |
| Name 3 mixed agonist/antagonist drugs | Butorphanol, Nalbuphine, Pentazocine |
| What drug is a partial agonist? Problem? | Buprenophine, naloxone w/ this may not be effective in reversing respiratory depression |
| What drug is used for reversal of an OD | Nalxone: Narcan’ |
| Which drug is used to prevent relapse in opiod dependednt pt’s (following opioid detox) | Naltrexone: also for alcohol dependence |
| What is a pseudoallergy to opioid administration | flushing, itching, sweating, mild hypotension |
| What drugs should we try to avoid with a pseudoallergy | codeine, morphine, meperidine, do use more potent w/o histamine release |
| Sol’n to a true opioid allergy | use opioid in different chemical class w/close monitoring |
| Non pharm tx options for pain | TENS, biofeedback, PT |
| What other program should be started when we start a pt on opioids? | bowel program, frequent constipation |
| Name 4 adjuvant analgesics for persistant pain besides NSAIDS and APAP | Tricyclic antidepressants (TCAs), Antiepileptic drugs (AEDs), Serotonin norepi reuptake inhibitor (SNRI), Selective serotonin reuptake inhibitors(SSRIs) |
| Which drugs are good for bone pain | NSAIDS |
| MOA of TCAs | Inhibit NE and 5-HT reuptake |
| MOA of AEDs | ↓synaptic transmission and inhibit neuronal activity, ↓release of glutamate, substance P |
Created by:
streetsmarts
Popular Pharmacology sets