analgesics

Question 1

chronic pain

Answer 1

lasting 3-6 months

Question 5

somatic

Answer 5

musculo-skeletal

Question 6

visceral

Answer 6

organs, smooth muscle

Question 7

superficial

Answer 7

skin/ mucous membrane

Question 8

referred

Answer 8

away from the organ of origin, follows nerve pathways

Question 9

neuropathic

Answer 9

pathological nerve change
- nerves affected

Question 10

phantom

Answer 10

amputation
confused nerve endings

Question 11

threshold

Answer 11

physiological response
level of stimulus needed to produce pain usually the same for all people

Question 12

tolerance

Answer 12

amount of pain a person can handle without interfering with normal function

Question 13

what does tissue injury cause the release of

Answer 13

Prostaglandins*
Bradykinin
Histamine
Potassium
Serotonin

Question 14

analgesics MOA

Answer 14

bind to opioid receptors endorphins and enkephalins

Question 15

primary opioid receptors

Answer 15

Mu
Kappa
Delta

Question 16

indications

Answer 16

alleviate moderate to severe pain

Question 17

adjuvant therapy

Answer 17

medicines given after the main treatment
- NSAIDS
- antideps
- antoconvs
- corticosteroids

Question 18

most serious SE of opioids

Answer 18

respiratory depression

Question 19

interactions with analgesics

Answer 19

alcohol
CNS depressants
- barbiturates
- benzodiazepines
- phenothiazines

Question 20

use analgesics with extreme caution in

Answer 20

repspiratory insufficiency
elevated ICP
morbid obesity
sleep apnea
paralytic ileus

Question 21

use morphine with extreme caution in …

Answer 21

head injury
gallstones

Question 22

what is 5x more potent than morphine

Answer 22

hydromorphone

Question 23

oxycodone CR

Answer 23

give alone or with acet.
lasts 12 hrs
not PRN
great risk of resp. depression
severe chronic pain

Question 24

meperidine

Answer 24

meperidine-like drug
caution in geriatrics
may cause seizures
tz not to exceed 48 hours
dose less than 600 mg in 24 hours

Question 25

fentanyl (duragesic)

Answer 25

• patches
• often for cancer induced pain
• chronic pain
• IV form commonly given

Question 26

methadone like drugs

Answer 26

methadone (dolophine)
buprenophine
naloxone (suboxone)
detox for addicts

Question 27

tramadol (utram)

Answer 27

Centrally acting synthetic opioid
Weak bond with mu receptor
Still check respiratory rate
(basically a lower level narcotic)

Question 28

tolerance

Answer 28

a common physiologic result of chronic opioid treatment

Question 29

dependence

Answer 29

physiologic adaptation of the body to the presence of an opioid
not addiction

Question 30

psychological dependence

Answer 30

drug addiction
pattern of compulsive drug use charectarized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief

Question 31

clinical opioid withdrawal scale

Answer 31

(COWS)
- anxiety, irritability, confusion
- lacrimation, rhinorrhea
- chills, diaphoresis, hot flashes
- N/V/D, GI cramping
- joint pain