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PHM 114
Chapter 9 & 10
| Question | Answer |
|---|---|
| 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 |
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Tara3184
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