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PHARMACOLOGY > 6. PAIN MANAGEMENT > Flashcards

6. PAIN MANAGEMENT Flashcards

1
Q

what is pain

A

=unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage.
-unpleasant feeling,
-protection from harm
>nociception, nociceptor

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2
Q

nociception neural processes of

A

encoding noxious stimuli

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3
Q

nociception is physiological perception of

A

pain

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4
Q

nociception does not require

A

consciousness and can continue unabated during general anesthesia if techniques that interrupt or inhibit transduction, transmission, and modulation of nociceptive stimuli are not included

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5
Q

nociceptor sensory receptor that

A

generate action potential (nerve impulse) and sends signals that cause perception of pain in response to potentially damaging stimulus

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6
Q

nociceptors - different nociceptors respond to different stimuli:

A
  1. mechanoreceptors: pressure and strech
  2. thermoreceptors: heat and cold
  3. chemoreceptors: inflammatory mediators (H+, K+, prostaglandins)
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7
Q

neuron includes

A

-dendrite
-nucleus
-axon
-cell body
-myelin sheath
-node of ranvier
-schwann cell
-axon terminal

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8
Q

nociceptive impulses are transmitted in

A

Adelta and C fibers
> Adelta -small myelinated fibers: fast, sharp pin
> C - smallest unmyelinated fibers : slow dull pain

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9
Q

transduction of noxious stimulus(any damage of tissue) > primary afferent nociceptor > transmission >

A

modulation > thalamus > thalamocortical projections > cortex > PERCEPTION

-modulation=changing - change signal to stronger or action let signal to main brain at all

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10
Q

modulation of pain in

A

spinal cord, many receptors and mediators modulate information passing to brain

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11
Q

modulation of pain excitatory transmitters

A

=prostaglandins > propagate pain impulse

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12
Q

modulation of pain inhibitory transmitters

A

=endorphins, epinephrine, norepinephrine, GABA > reduce painful stimuli

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13
Q

gate theory small fibers and large fibers >

A

pain

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14
Q

hyperalgesia increased sensitivity to

A

pain, which may be caused by damage to nociceptors or peripheral nerves or lack of inhibitory transmitter

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15
Q

primary hyperalgesia (kipuaistin lisääntyminen suoraan tulehtuneessa tai vahingoittuneella alueella) describes pain that occurs

A

directly in damaged tissues

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16
Q

secondary hyperalgesia (Kipuaistimuksen lisääntyminen tapahtuu alueilla, jotka ympäröivät vahingoittunutta aluetta mutta eivät ole itse suoraan vahingoittuneet) describes pain sensitivity that occurs in

A

surrounding undamaged tissues

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17
Q

hyperalgesia is

A

opioid -induced

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18
Q

allodynia (tilaa, jossa normaalisti kivuttomat ärsykkeet aiheuttavat kipua) pain due to

A

stimulus that does not usually provoke pain

19
Q

tactile allodynia pain caused by

A

touch

20
Q

mechanical allodynia caused by

A

movement across skin

21
Q

thermal (temperature-related) allodynia caused by

A

heat or cold that is not extreme enough to cause damage to your tissues

22
Q

movement allodynia pain triggered by

A

normal movement of joints or muscles

23
Q

nociceptive pain: acute response to

A

tissue damage that resolves in period of days

24
Q

nociceptive pain: chronic pain lasts for

A

longer period of time, classically associated with chronic inflammatory disease or degenerative condition or following nerve injury or damage
>degenerative joint disease
>stomatitis
>intervertebral pathology

25
Q

somatic pain: superficial somatic pain in

A

-skin, subcutaneous tissue
-well localized, sharp, burnin
-burns, wound, contusions

26
Q

somatic pain: deep somatic pain

A

-muscles, joints, bones, fascia
-localized or diffuse
-dull, spastic
-arthritis, tendonitis etc

27
Q

visceral pain-pain that results from

A

activation of nociceptors of thoracic, pelvic or abdominal organs (viscera)

28
Q

visceral pain-nociceptive fibers together with

A

autonomic nervous system

29
Q

postoperative pain form of

A

acute pain due to surgical trauma
> inflammatory component
>tissue irritation from extravascular blood
>peripheral and central sensitization

29
Q

visceral pain etiology

A

-distention(strech)
-ischemia
-inflammation
-not so sensitive to cutting or burning

30
Q

neuropathic pain that develops following injury to

A

peripheral nerves and central nervous system (spinal cord, brainstem, brain)
> accompanied by hyperalgesia and allodynia to both inflammatory and normally non-painful stimuli
>spontaneous action potential
>in humans common as postamputation pain: limbs, tail, eye

31
Q

phantom pain perceptions that individual experiences relating to

A

limb or organ that is not physically part of body anymore
>develops after amputation of limb, eye, testicles, tail, mastectomy
> pain formed from injured nerve endings at stump site
>pain prior amputation increases risk of phantom pain

32
Q

consequences of pain-cardiovascular system

A

-tachycardia
-hypertension
-increased myocardial oxygen requirements
-cardiac arrhythmias
-coagulation

33
Q

consequences of pain-respiratory system

A

-hyperventilation
-atelectasis
-pulmonary edema

34
Q

consequences of pain-central nervous system

A

-affected behaviour
-depression
-aggression
-dilated pupils
-sleep disturbances

35
Q

consequences of pain-GIT

A

-delayed gastric emptying
-ileus
-nausea
-vomiting
-loss of appetite

36
Q

consequences of pain-urinary system

A

-oliguria
-urinary retention
-postanesthetic kidney failure

37
Q

consequences of pain-immune system

A

-pro-inflammatory cytokines increase
-anti-inflammatory cytokines decrease
-unfections decrease
-spread of cancer increase

38
Q

pain assessment

A

1-5

39
Q

perception of pain perceptual phenomenon requires

A

conscious being
=kivun havaitseminen ja kokeminen

40
Q

perception of pain always includes

A

suffering

41
Q

assessment to chronic pain

A

-general mobility-ease of movement, fluidity of movement
-performing activities - playing, hunting, jumping, using litter-box
-eating, drinking
-grooming
-resting.observing, relaxing
-social activities involving people and other pets
-temperament

42
Q

parts of perception of pain

A

-sensory factors: injury, inactivity, body mechanics
-cognitive factors: focus on pain, changes in behavioral patterns
-emotional factors: depression, agression, anxiety, stress

43
Q

multimodal analgesia is most

A

effective and due to low doses of any single drug, provides less side effects

PHARMACOLOGY (14 decks)

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