7.1 Fundamental principles of cancer pain management Flashcards
What are the pain initiators (NTs) and which are central and peripheral
Glutamate: cetrral
Substance P: central
bradykinin: peripheral
Prostaglandins: peripheral
What are the pain inhibitors?
Serotonin
Endorphins
Enkephalins
Dynorphin
What are the three factors that influence he gate control theory?
Amount of activity in pain fibres
Amount of activity in other peripheral fibres
Messages that descend from the brain
What ‘opens’ the pain gate?
Extent of injury Inappropriate activity level Anxiety or worry Tension Depression Focusing on pain boredom
What ‘closes’ the pain gate
Medications Counter stimulation (heat, massage) Positive emotions Relaxation/rest Intense concentration or distraction Involvement and interest in life activities
What is the treatment of mild to moderate pain?
Non opioids - aspirin, NSAIDs or paracetamol
What is the treatment for moderate to severe pain?
Mild opioids (codeine) with or without non opioids
What is the treatment for severe pain?
Strong opioids (morphine) with or without non opioids
What changes the personal context of pain?
Previous treatment experiences
Impact on QoL
Expectations of relief