Advanced Pain Flashcards
The normal response to a noxious stimuli, as in tissue injury, that tells the brain, this is painful!
Nociceptive (physiologic) pain
Pain associated with Surgical, trauma, wound, burn, tumor or infection of an organ
Nociceptive (physiologic) pain
Abnormal processing of sensory from damage to peripheral and / or CNS.
Neuropathic (pathophysiologic) pain:
Phantom pain from peripheral nerve damage, post-herpes neuralgia, diabetic neuropathy
Neuropathic (pathophysiologic) pain:
CCPOT
Critical Care Pain Observation Tool
Antidepressants block the body’s uptake of
serotonin (leaving more available) which fights pain
Opioid receptors located thorough body (CNS, peripheral nervous system, GI tract) responds to
natural endorphins released in stress
Non-Nociceptor A Fibers –
applying ice, heat, rubbing – can block/decrease pain
Serotonin and Norepinephrine released in descending fibers to
‘inhibit’ pain
PCA drugs
Morphine / Hydromorphone / Fentanyl
Medication injected into the subarachnoid space for surgery, temporary loss of sensation/motor at level below block
Spinal
Medication injected into space between the outermost meninge and the vertebral canal. Analgesia, no loss of motor control
Epidural
Surgically implanted and attached to implanted or external infusion device
Long term Epidural catheters
Advantages of Epidural / Spinal Route:
No systemic side effects!
Long acting morphine for post op pain relief. Small dose given!
Duramorph
start with the smallest dose that provides satisfactory relief
Titration:
Determines which drug to give
Pain Scale
a sign of pain
Shallow respiration
Narcotic Antagonist
NALOXONE
Pain med that has no effect on inflammation
Acetaminophen
Leading cause of acute liver failure
Acetaminophen
Non-Pharmacological Pain Interventions
TENS, Physical , Occupational, & Psychosocial therapy
Patient Education
Drug interactions and herbal remedies:
aspirin, warfarin, Ticlid, Plavix
Gingko
Drug interactions and herbal remedies:
antidepressants
St. John’s Wort:
Drug interactions and herbal remedies:
warfarin
Ginseng:
Drug interactions and herbal remedies:
decongestants
Ephedra
Titration
Starting with the smallest dose
Leading cause of acute liver failure
Acetaminophen
