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PHM 114

Chapter 9 & 10

Pain unpleasant sensation and an emotional response with an important biological function
Peripheral nervous system responsible for detecting temperature and touch as well as pain
Inflammation causes a cascade of events starting with the release of arachidonic acid
Pyrogens substances that produce fever
acute pain sympathetic nervous system: pulse increase,blood pressure rises,breathing speeds up,muscles tense,and pupils dilate
Chronic pain lasts longer than 3 months and may not be associated with sympathetic manifestations such as acute pain
Somatic Pain comes from injury to the body frame such as to bones and muscles
Visceral pain comes from problems with internal organs such as the kidneys or intestines
Neuropathic pain comes from damage to nerve tissue itself. symptoms are tingling, burning, or stabbing pain in area of injury
Sympathetically mediated pain associated with nerve overactivity. patient feels pain when there is no obvious stimulus for it
Phantom limb pain patient feels pain in a limb that is no longer there such as an amputated leg
Tolerance body becomes less sensitive to the effects of a drug over time. higher and higher dose needed
Physiological Dependence body becomes used to the effects of a drug over time and physically adjusts
Psychological Dependence related to euphoric effects and relief that a patient feels when analgesia for legitimate pain occurs
Addiction compulsive behavioral disorder in which the patient becomes preoccupied with opiates or narcotics above all other drugs
Acetaminophen mild pain and fever reliever. used in combination with opiates for moderate to severe pain.
Synergistic drug therapy combining non narcotic analgesic with opiate drugs which achieves pain relief. smaller doses are needed and fewer side effects occur
What is acetaminophen used for? pain associated with headache or osteoarthritis, and for children with pain or fever
Which drug does not have an appreciable anti inflammatory effect? acetaminophen
Aspirin mild to moderate pain and fever reliever.
What is aspirin used for? to treat pain associated with inflammation, OA, menstrual cramps, in low doses for stroke and heart attack prevention. in combination with opiates for moderate to severe pain
Side effects of aspirin? stomach upset, gastrointestinal irritation, erosion, and bleeding, headache, dizziness, rash. Take with food to lessen.
What can cause exacerbate gout? aspirin
What are signs of aspirin toxicity? ringing in the ears, dizziness, and confusion
Cautions and considerations of aspirin? contraindicated in patients who have asthma or are pregnant. some patients allergic. associated with Reyes syndrome.
Narcotic analgesics relief for moderate to severe pain . opiate derivatives similar in action to morphine
Headache specific type and location of pain cause by migraine, tension, or neuralgia, and can be side effect of many drugs and other conditions
Migraine Headache characterized by throbbing, unilateral pain in the head that impacts normal activity of life. thought to be vascular phenomenon caused when cerebral surface blood vessels constrict and then rapidly dilate
Medication overuse headache occurs when triptans are used more than 6 times a month and other analgesics are used 3 or more times a day for 3 to 5 days a week
When should preventive treatment be used for migraine? when you have more than 2 or 3 a month
When should abortive treatment be used? whenever migraine occurs.
Triptans- Selective serotonin receptor agonist mainstay of abortive therapy for migraine pain.
What are the side effects of triptans? DIZZINESS, hot flashes, tingling, chest tightness, muscle aches, weakness, increased blood pressure, and sweating
Preventive drug therapy indicated when migraines affect normal life activities and occur more than twice a month.
What drugs are used for migraine prevention? beta blockers, antidepressants, anticonvulsants, calcium channel blockers, NSAIDS
Anesthesia inhibits sensation and pain during procedures such as surgery, dental work, and colonoscopy. used during obstetric and diagnostic procedures
General Anesthesia affects the entire body, and loss of consciousness occurs. used for surgery and other procedures for which overall muscle relaxation is necessary to keep the patient still during manipulation
Which general anesthetic is used during dental work to relax patient and provide analgesia? nitrous oxide. available in inhaled an injectable forms
Inhaled anesthetics compressed gas or liquid and inhaled through a face mask. reduce blood pressure so IV has to be given
What are side effects of general anesthetics? nausea, vomiting, decreased blood pressure, and reduced renal function, respiratory function surpressed
Malignant hyperthermia body temp rises suddenly and rapidly to dangerous levels, accompanied by heart arrhythmias, difficulty breathing, muscle rigidity
What drug is used to treat malignant hyperthermia? Dantrolene. intracellular calcium blocker
Local anesthesia affects only a select part of the body causing loss of pain, tactile sensation, and temperature sensation.
Preanesthetic medications used for short diagnostic procedures or to enhance relaxation, pain control, and amnesia associated with surgery
Local anesthetics used for dental work, stitches, and sutures.
Esters short acting drug molecules metabolized by local tissue fluids
Amides longer acting drug molecules metabolized in the liver
Local anesthetics side effects? allergic reaction, skin rash, and swelling at application site, and CNS excitation
Naloxone(narcan) opiate receptor antagonist that counteracts opioid pain and preanesthetic medications. used to reverse opiate effects in intentional and accidntal overdose
Flumazenil(romazicon) a benzodiazepine receptor antagonist used to reverse excessive sedation. used to speed recovery of consciousness in accidental or intentional overdose situations
Caffeine CNS stimulant used in combination with other analgesics for headache
Feverfew plant product used orally for migraine pain, menstrual cramps, and arthritis
Muscular system responsible for movement, posture, and body heat
Skeletal muscles connected to bones and joints by tendons and provide voluntary movement
Cardiac muscle in the heart. pumping and squeezing action required for each heartbeat
Smooth muscle in the intestines and blood vessel walls
Peristalsis kind of movement that pushes material through tubes, such as when food progresses through the intestines
Neuromuscular Junction where nerve cells interface with muscle cells to initiate muscle contraction
Acetylcholine neurotransmitter that is released from the nerve cell, travels across the synaptic cleft, and stimulates muscle cell receptors to cause membrane depolarization
Depolarization changes balance of positive and negative electrical charges along membrane surface and opens channels, allowing sodium to enter
Intramuscular injection in deltoid or gluteus medius. in children in the vastus lateralis
mL in deltoid? 2
mL in gluteus medius? 5
Spasm involuntary contraction of muscle fibers
Muscle spasticity muscles become rigid and difficult to control for coodinated movement. Caused by brain damage, spinal cord injury, multiple sclerosis, cerebral palsy, or malignant hyperthermia
Central nervous system depressants muscle relaxants that block ssignals coming from the brain and spinal cord that control muscle contraction. used as anticonvulsants and antianxiety agents
Drugs used chronically for muscle spasticity? baclofen and tizanidine
Side effects of centrally acting muscle relaxants? sedation is most common. drowsiness, dizziness, fatigue, confusion, impaired judgement, altered coordination
What is the one drug that needs heightened monitoring for abuse and addiction? Carisoprodol- Soma
Botulinum toxin blocking release of ACh in neuromuscular junction. reduce facial lines and wrinkles
Hyperhidrosis excess sweating
Direct acting muscle relaxant Dantrolene. blocks intracellular release of calcium and weakens muscle contractility. used for muscle spasticity die to spinal cord injury or cerebral palsy. drug choice for malignant hyperthermia
Neuromuscular blockers cause temporary paralysis. used with anesthesia for shourt term muscle relaxation during endotracheal intubation, mechanical respiration, and surgical procedures. blocks ACh receptors allowing muscle to continuously contract
Side effects of neuromuscular blocking agents? low blood pressure and respiratory depression
Rhabdomyolysis syndrome where muscle breakdown occurs and toxic cell contents are release into bloodstream - Statins
Fibromyalgia chronic muscle pain condition. symptoms are pain in neck, back, shoulders, chest, arms, and legs
Myasthenia gravis autoimmune process that attacks and destroys ACh receptors. muscle weakness in face and neck and eventually impairs movement in limbs
Poliomyelitis infection of the nerves that control muscular system
Muscular dystrophy group of genetically acquired conditions causing muscle atrophy (shrinking) and wasting
Chapter 9. What kind of patients shouldnt take triptans? with high blood pressure. heart disease. angina
Preanesthetic medications used for short diagnostic procedures or to enhance relaxation, pain control, and amnesia associated with surgery
Created by: Tara3184



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