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Year 2: Pharmacology for nursing practice > Analgesia > Flashcards

Analgesia Flashcards

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1
Q

Is pain pathological or physiological?

A

both

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2
Q

What type of pain do we want to get rid of?

A

Pathological pain

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3
Q

What is nociception?

A

perception of pain

how the sensory nervous system responds to harmful or potentially harmful stimuli

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4
Q

What are thye 4 components of loeser’s concept of pain?

A

Nociception

pain

suffering

pain behaviours

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5
Q

What is neuropathic pain?

A

Pain which is caused by damage or disease affecting the somatosensory nervous sytem

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6
Q

Why is pain integral to the process of inflammation?

A

promotes healing by limits use of affected areas

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7
Q

Do we have pain receptors in the body?

A

No, other receptors which detect other stimuli contribute to the nociception of pain.

When sensory stimuli reaches a certain threshold for a receptor, pain can be felt

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8
Q

List some examples of source of pain

A

Trauma

Inflammation

ischaemia

post-operative pain

neuropathic pain

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9
Q

Define acute pain.

A

Response to traumatic injury, natural or therapeutic process

lasts less than three months duration

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10
Q

What type of pain lasts less than three months?

A

acute pain

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11
Q

Define chronic pain

A

pain lasting more than 3 months duration.

underlying cause potracted or on-going, may not be identifiable.

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12
Q

What type pain is on-going and may be poorly localised?

A

chronic pain

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13
Q

List the benefits for treating pain in patients

A

Humanitarian - rewarding

cost-effectivenss - fewer complications

reduced complications for patient

reduced physiological stressors

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14
Q

Why are some surgeons reluctant to pescribe opioids post op?

A

Opioids can alter physiological process in the following ways

Repress respiration rate -you want to get patient out of bed as soon as possible

lower blood pressure - undesirable after vascular surgery.

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15
Q

Why might a surgeon be be reluctant to prescribe opioids after vascular surgery?

A

Blood pressure is lowered can lead to renal failiure

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16
Q

what are the main 2 management options for pain?

A

Block Transmission (e.g. local anesthetics)

attenuate source of pain (i.e. reduce inflammation, NSAIDs)

remove source of pain (i.e. surgery)

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17
Q

What knowledge is key to effective pain management?

A

pain transmission

modes of action of analgesic drugs

pain assessment

side - effects/ adverse reactions

evaluate medication

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18
Q

Give examples of pharmacological pain relief routes

A

oral/enteral

intra-venous

patient controlled analgesia (PCA)

subarachnoid/ epidural

localised infiltration

nerve block

rectal

subcutaneous

sublingual

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19
Q

Why is it not advised to give respiratory patient inhalation anesthetic? what is usually given instead?

A

Theses types of analgesia may lower respiration rate

can make patient very lethargic

anaesthesia usually given via spinal route

20
Q

Is the half life for inhalation anesthesia usually long or short?

A

short

21
Q

Why are bariatric patients usually given spinal anesthesia over inhalation anaesthesia?

A

Bariatric patients usually hold a high amount of adipose tisssue.

gaseous anaethtic goes to their skin.

Since half life of gaseous anaesthesia is short, a high dose needs to be administered to saturate fat before it infiltrates the bloodstream.

this could lead to respiratory arrest due to large amount of medication seeping out of adipose tissue even after administration

22
Q

What is a common sublingual pain relief medication?

A

GTN

23
Q

What are the two major forms of analgesia?

A

opioids and non-opioids

24
Q

give examples of common non-opioid medication?

A

morphine

pethidine

codeine

25
Q

Give examples of common non-opioid medication?

A

aspirin,paracetamol, diclofenac, ibuprofen

26
Q

what term could describe an opioids agonists or antagonists?

A

agonist

27
Q

Describe the action of opioids in modulating pain relief

A

opioid molecules binds toreceptors on preganglionic nerves thus open up K+ channels allowing potassium to flow out of the cell preventing depolarization wave to move through the nerve cell. therefore neurotransmitter cannot be release

28
Q

Why can opiods be described as agonist?

A

They mimic the action of endogenous ligands (endorphins, ekephalins, dynorphines) to enhance action.

29
Q

Which of the following endogenous ligands neurotransmitters or hormones:

enkephalins
endorphines
dynorphines

A

horme: endorphine
neurotransmitters: enkephaline, dynorphine

30
Q

What is deccusation?

A

when fibers cross from one side of a structure to the other

31
Q

What term describes when fibers cross from one side of a structure to the other?

A

deccusation

32
Q

List some of the effects of opioids.

A

cough centre depression

diaphoresis

euphoria

pupil constriction

flushing

respiratory, rate and rhythm depression.

vasodilation

smooth muscle constriction - billiary spasm

decreased peristalsis

increased bladder tone

33
Q

can an increase in opioids cause receptor upregulation or down regulation?

A

down regulation

34
Q

When blood pressure drops to low, which organ is most affected?

A

kidney’s

35
Q

What is the most important clinical side-effect which is induced by opioids?

A

decreased peristalsis

36
Q

What is meant when a drug has a high first pass effect?

A

it has a high affinity to be metabolised by the liver thus greatly reducing concentration

37
Q

What acute adverse side effects are associated with opioids?

A

respiratory depression

vascular smooth muscle vasodilation:
hypotension ->renal impairment->Reduced drug clearance

38
Q

What are the contra-indications for using opioids>?

A

Head injuries

pregnancy/lactation

39
Q

Why is head injury a contra-indication for taking opioids?

A

risk of brain pressure

impairs brain function assessment

40
Q

Why is Pregnancy/;actation a contra-indication for taking opioids?

A

Passes through placental barrier and can cause respiratory depression and hypotension in the baby

41
Q

Which opioid is an exception for pregnant/lactating women?

A

pethidine

42
Q

What are the nursing care implications for patients prescribed with opioids?

A

Properly assess patient prior to administration of drug i.e.:

other conditions-disorders present

previous meds

sensitivity to opioids

43
Q

What nursing care must be implemented on a patient who is on opioids?

A

monitor vital signs

overdose treatment?: Naloxone

Monitor for adverse effects

44
Q

What medication treament is administered to patient who may have overdosed on opioids?

A

Naloxone

45
Q

What consideration should be taken into account prior to administering an opioid to a patient?

A

depenedence

toloerance

age

pregnancy/lactation?

pain assessment

Year 2: Pharmacology for nursing practice (13 decks)

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