Analgesia

Question 1

Analgesia is…

Answer 1

absence of awareness of pain

Question 2

Pain is…

Answer 2

an unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 3

what can untreated pain lead to?

Answer 3

patient suffering and prolongs recovery from surgery, injury, or illness

Question 4

what are the physiological consequences of pain?

Answer 4

1. Stress hormone release
2. Immunosuppression
3. Increased inflammation
4. Delayed wound healing

Question 5

what is nociception?

Answer 5

detection of actual or potential tissue injury (i.e. pain) by the CNS

Question 6

what are nociceptors?

Answer 6

nerve cells involved in the detection of pain

Question 7

what are the steps involved in pain perception? (4)

Answer 7

1. Transduction
2. transmission
3. modulation
4. perception

Question 8

Transduction is…

Answer 8

transformation of noxious thermal, chemical, or mechanical stimuli into action potentials by peripheral A-delta and C fibers

Question 9

what is the nociception of A-delta fibers?

Answer 9

sharp descrete pain that can be localized like a cut on the skin

Question 10

what is the nociception of C fibers?

Answer 10

dull aching and throbbing pain hard to localize like pain in organs

Question 11

Transmission is…

Answer 11

conduction of sensory electrical impulse to the spinal cord

Question 12

Modulation is…

Answer 12

neurons in the spinal cord amplify or suppress the sensory impulse received from the peripheral nociceptors

Question 13

Perception is…

Answer 13

a sensory impulse is transmitted to the brain, where it is processed and recognized as pain

Question 14

Multimodal analgesia is…

Answer 14

using a combination of analgesic drugs, each with a different mechanism of action, to control pain

Question 15

what are the classifications of pain?(2)

Answer 15

1. adaptive

2. maladaptive

Question 16

Adaptive pain is…

Answer 16

the normal sensory response caused by tissue damage and inflammation (acute or chronic)

Question 17

Maladaptive pain is…

Answer 17

results from physical changes that occur in the normal spinal cord and brain if adaptive pain is not managed appropriately

Question 18

what can constant stimulation of the nociceptors lead to?

Answer 18

physical/chemical changes in the spinal cord that make them more sensitive to stimulation

Question 19

Hyperalgesia is…

Answer 19

increased sensitivity to noxious stimuli

Question 20

Allodynia is…

Answer 20

pain produced by non-noxious stimuli

Question 21

Windup is…

Answer 21

CNS hypersensitivity to noxious and non-noxious stimuli

Question 22

Somatic pain is…

Answer 22

arising from skin, SC tissue, muscle, bones, or joints

Typically transmited along A-delta fibers

Question 23

Visceral pain is…

Answer 23

arising from internal organs

Typically transmitted along C fibers

Question 24

Neuropathic pain is…

Answer 24

pain arising from direct damage to peripheral nerves or the spinal cord

Question 25

Acute pain is...

Answer 25

sudden onset, short duration

Question 26

Chronic pain is...

Answer 26

slow onset, long-lasting

Question 27

how is pain determined in animals?

Answer 27

physiologic and behavioral changes

Question 28

what are some physiologic changes with pain?

Answer 28

cardiovascular, respiratory, and ocular systems

Question 29

what are some observable changes of pain?

Answer 29

posture, movement, vocalization and behavior

Question 30

how frequent should pain assessment be performed on patients?

Answer 30

frequently during the first few

Question 31

when should pain assessment be performed? (2)

Answer 31

1. after an animal undergoes major surgery | 2. when they come into the hospital

Question 32

how is pain treated? (2)

Answer 32

1. Eliminate the primary cause | 2. Use of analgesic drugs

Question 33

what are the analgesic drug administration times? (2)

Answer 33

1. Preemptive Analgesia | 2. Postoperative analgesia

Question 34

when is preemptive analgesia administered?

Answer 34

before tissue damage occurs or the patient has awareness of pain

Question 35

what is the purpose of giving preemptive analgesia help with?

Answer 35

Reduces the analgesic requirement as well as how long the patient will need analgesics for pain control

Question 36

when is postoperative analgesia administered?

Answer 36

few hours to a few days following surgery

Question 37

what are some analgesic drugs? (5)

Answer 37

``` Opioids NSAIDs Local anesthetics Ketamine Alpha-2 agonists ```

Question 38

why are CRI analgesia drugs more common for pain relief?

Answer 38

1. Provide stable plane of analgesia 2. No peaks or troughs 3. Lower drug dosage delivered at any point in time 4. Greater control over drug administration

Question 39

which analgesics can be used for CRI?

Answer 39

1. Opioids 2. Lidocaine 3. Ketamine 4. Alpha-2 agonists

Question 40

what are the analgesic properties of opioids? (2)

Answer 40

1. Moderate to severe pain | 2. Mild to moderate pain

Question 41

what are some opioids for moderate to severe pain? (4)

Answer 41

1. Morphine 2. oxymorphone 3. hydromorphone 4. fentanyl

Question 42

what are some opioids for mild to moderate pain? (4)

Answer 42

1. Buprenorphine 2. butorphanol 3. meperidine 4. nalbuphine

Question 43

what is the drug effect of morphine?

Answer 43

Agonist

Question 44

what receptors does morphine bind to?

Answer 44

mu and kappa receptors

Question 45

what is a potential side effect when giving morphine IV?

Answer 45

histamine release

Question 46

what routes can morphine be given?

Answer 46

IV, IM, SC, epidural, (PO)

Question 47

what can morphine cause with horses?

Answer 47

bradycardia colic

Question 48

what drug effect does oxymorphone and hydromorphone have?

Answer 48

Agonists

Question 49

what receptors does oxymorphone and hydromorphone bind to?

Answer 49

mu receptors