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What are the three etiologies of pain?
Disease related
Trauma related
Treatment related
What are 10 health consequences of pain?
Increased:
Stress
Metabolic Rate
Blood Clotting
Water retention
Hormone imbalance
Decreased:
Immune system
Healing
GI Function
Mobility
Appetite
Sleep
What is positively correlated with high pain scores?
Post-op pulmonary complication
Why does pain lead to poor wound healing?
Vasoconstriction
Why does pain lead to deep vein thrombosis?
Venous stasis from immobility
Why does pain lead to vasoconstriction?
Sympathetic nervous system activation
What are three types of pain?
Somatic
Visceral
Neuropathic
Which type of pain is well-localized and comes from structural tissues?
Somatic Pain
Which type of pain is deep and refferred and comes from deep tissues and organs as a result of stretching, distention or ischemia?
Visceral pain
Which type of pain is shoot, burning or stabbing and comes from the peripheral receptors?
Neuropathic pain
What two areas modulate pain?
Nociceptors
Dorsal horns of the spinal cord
When does pain become perceived as a localized sensation?
When it reaches the sensory cortex
Five factors to consider when assessing pain?
P - Q - R - S - T
Provokes
Quality
Radiates
Severity
Timing
What is the first step of the WHO Analgesic Ladder and what does it treate?
Nonopioid analgesics, mild to moderate pain
What is the second step of the WHO Analgesic Ladder and what does it treat?
Opioid analgesic, more severe pain
What is the third step of the WHO Analgesic Ladder and what does it treat?
morphine, fentanyl, severe pain
What are three categories of non-opioid drugs?
Topical
Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)
Para-aminopheno derivatives (acetaminophen)
What is a common topical nonopioid?
Capsaicin
What is Capsaicin's mechanism of action?
Depletes Substance P
What are two kinds of opioid receptors?
Mu
Kappa
What are six common side effects of opoiod drugs?
Sedation
Dependency
Respiratory Depression
Decreased GI motility
Euphoria
Analgesia
What are the side effects correlated to mu receptors (mu agonists)?
All of them
What opioid drug side effects correlate to Kappa receptors?
Analgesia
Sedation
Decreased GI motility
Which opioid drug side effects are not connected with kappa receptors?
Euphoria
Respiratory depression
Dependency
What is drug tolerance?
physiological process of desensitization of receptors requiring increase in dose to get same analgesia effect
What are the seven routes of administration when dealing with opioids?
Intravenous
Intramuscular
Oral
Rectal
Transdermal
Sublingual
Buccal
What are the disadvantages of administering opioids orally?
Nausea and vomiting
Decreased GI function
What are the disadvantages of administering opioids rectally?
Improper application
What are the disadvantages of the transdermal route of administering opioid drugs?
Difficult to titrate
Toxicity may continue after removal
Expensive
What are the disadvantages of administering opioids sublingually/buccaly?
Low bioavailability
Taste
No fluids after dose for 15 min.
inconvenient with large dose
Which opioid is a kappa agonist?
Pentazocine
Which opioids are mu agonists?
Morphine
Meperidine (Demerol)
Fentanyl
Oxycodone
What is given when someone overdoses on opioids?
Naloxone
Which opioid's dosing is limited by aspirin and acetaminophen?
Oxycodone
Which opioid when overdosed is lethal?
Fentanyl
What is a disadvantage of oxycodone?
It cannot be crushed
Dose limited by ASA and Acetaminophen
Which opioid drug increases intracranial pressure?
Pentazocine
What is the disadvantage of using meperidine?
Toxic metabolite inhibits long term use.
What is the name of the drug that blocks mu receptors in the intestines?
Methylnaltrexone
What is a disadvantage to giving naloxone for opioid overdose?
It has a shorter half-life than most opioids
What are two types of nonopioid adjuvants?
Tricyclic Antidepressants
Anticonvulsants
What do tricyclic antidepressants do?
Block NE and serotonin reuptake which inhibits Substance P release
What do anticonvulsants do to relieve pain?
Decrease nerve conduction, steroids stabilize mast sells which decreases histamine and swelling
Three things to consider when dosing pain medication...
By the ladder
By the clock
By the least invasive route
Author
sashatom
ID
35097
Card Set
Pain
Description
Pain lecture slides
Updated
2010-09-16T06:06:58Z
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