analgesia

Question 1

pain elicits…

Answer 1

protective motor action (biting), learned avoidance (fear), modifies species behavior (hiding)

Question 2

untreated pain can effect…

Answer 2

heavior, psychology, metabolism, immune system

Question 3

nociception

Answer 3

detection by the nervous system for potential tissue injury, protects animal from painful or noxious stimuli

Question 4

physiological pain

Answer 4

ouch pain, little or no tissue injury, protects from injury

Question 5

pathological pain

Answer 5

follows tissue injury, no useful function, causes suffering, acute or chronic

Question 6

classification based on mechanism

Answer 6

inflammatory, neuropathic, cancer, idiopathic

Question 7

classification based on origin

Answer 7

visceral (organ) or somatic (musculoskeletal)

Question 8

classification based on severity

Answer 8

none, mild, moderate, severe

Question 9

pain pathway step 1

Answer 9

transduction: transformation of stimuli into sensory electrical signals (action potentials)

Question 10

pain pathway step 2

Answer 10

transmission: sensory impulses conducted to spinal cord

Question 11

pain pathway step 3

Answer 11

modulation: impulses are either amplified or suppressed

Question 12

pain pathway step 4

Answer 12

perception: impulses are transmitted to brain where they are processed or recognized

Question 13

multimodal therapy

Answer 13

targeting two or more receptors

Question 14

consequences of untreated pain

Answer 14

catabolism and muscle wasting, immune system suppression, inflammation and delayed wound healing, anesthetic risk, patient suffering

Question 15

peripheral hypersensitivity

Answer 15

area around primary wound is sensitive and painful

Question 16

secondary hyperalgesia

Answer 16

central nervous system hypersensitivity or windup, area of sensitivity is further away from site of tissue injury

Question 17

neuroendocrine changes

Answer 17

can results in catabolic state and wasting, ACTH release, elevated cortisol, norepi, and epi, decreased insulin

Question 18

sympathetic stimulation

Answer 18

can result in cardiac arrhythmias, vasoconstriction, increased myocardial work, increased O2 consumption

Question 19

preemptive analgesia

Answer 19

administering meds before the pain, reduces requirements of analgesia and duration, prevents windup

Question 20

behavioral responses

Answer 20

cats hide, dogs seeks owner comfort, herd animals separate themselves

Question 21

physical evidence in pain

Answer 21

changes in gait, level of activity, reluctant to lie down, shifting position, vocalization (growl, howl, whine, hiss, groan), changes in facial expression

Question 22

visual analog scales

Answer 22

left = pain
right= severe pain

Question 23

with effective analgesia…

Answer 23

pain-associated behaviors with decrease and pain score will decrease

Question 24

preemptive analgesia

Answer 24

pre op with pre meds, administered with anesthetic agents, fentanyl patch, NSAIDS

Question 25

multimodal therapy

Answer 25

use of one or more drugs to control pain, cover multiple receptors, reduce dose of individual drugs

Question 26

analgesia is needed at…

Answer 26

every stage of hospitalization and treatment

Question 27

choice of drug depends on…

Answer 27

severity of pain, P general condition, route of delivery

Question 28

using opioids as analgesics

Answer 28

often combined with tranquilizer, good for windup pain, not good for post op pain

Question 29

sedatives and antianxiety drugs can cause _____ in horses and cats

Answer 29

excitement

Question 30

post op opioids can be used

Answer 30

alone or with other drugs

Question 31

opioids are metabolized in the

Answer 31

liver

Question 32

morphine is used for…

Answer 32

moderate to severe visceral and somatic pain (pure agonists)

Question 33

morphine is a schedule

Answer 33

II

Question 34

side effects of morphine

Answer 34

GI stim in dogs and cats, colic in horses, miosis and hypothermia in dogs, mydriasis and hyperthermia in cats, bradycardia, ^ IOP, urine retention

Question 35

oxymorphone

Answer 35

pure opioid antagonist, greater analgesic property and sedative effect than morphine, fewer side effects

Question 36

what schedule is oxymorphone

Answer 36

II

Question 37

hydromorphone

Answer 37

opioid agonist, less potency but similar duration to oxymorphone

Question 38

hydromorphone schedule

Answer 38

II

Question 39

methadone

Answer 39

synthetic opioid, similar to oxymorphone and hydromorphone, least likely to cause vomiting in cats and dogs

Question 40

fentanyl

Answer 40

most potent analgesics known, rapid onset and short duration

Question 41

fentanyl schedule

Answer 41

II

Question 42

meperidine/pethidine

Answer 42

pure opioid agonist with less potent analgesic properties and shorter duration, wide margin of safety, used with NSAIDS for analgesia

Question 43

meperidine/pethidine schedule

Answer 43

II

Question 44

butorphanol

Answer 44

opioid agonist-antagonist, stims kappa receptors and blocks mu receptors, not as effective as pure agonists, less sedation, dysphoria, and resp depression

Question 45

butorphanol can be used to reverse the effects of…

Answer 45

morphine and fentanyl

Question 46

butorphanol schedule

Answer 46

IV

Question 47

buprenorphine

Answer 47

partial agonist, produces some analgesia for mild to moderate pain, delayed onset of action and longer duration of action

Question 48

buprenorphine schedule

Answer 48

III