Analgesics Flashcards
An analgesic is…
an agent that relieves pain
Pain is a subjective experience.
“Pain is defined as whatever the patient says it is, wherever and whenever the patient says it is.”
Pain Scale:
Generally 1-10
Pain Threshold
Physical element
how much pain is your body used to; what you’re feeling
Pain Tolerance
Psychological element
in your head, what can you live with; easier to affect; experience
Can have chronic pain with…
… acute flare-ups
Adjuvant Therapy
Assist primary agents in relieving pain = smaller doses
- decrease side effects
- approaches pain stimulus from another mechanism = synergistic effect
Synergistic
work together to achieve a better outcome; other ways to deal with pain - ice, heat, massage, relaxation technique
-Pharm - an anti-depressant might increase pain tolerance
Drug Tolerance
chemical; need progressively high doses to maintain same analgesic effect
having to bump up the dose
Drug Dependence
- Psychological: pattern of compulsive drug use; euphoria rather than pain relief
- Physical: sudden withdrawal of medication = withdrawal symptoms
Rebound Pain
Pain has returned and is worse than it was before
Withdrawal Symptoms
- Rebound pain, tachycardia, elevated BP, mental agitation
- Opioid withdrawal: anxiety, irritability, chills, hot flashes, joint pain, N/V, abdominal cramps, diarrhea
Moral/Ethical Considerations
- Placebos
- Chronic pain/terminal pain: fear of addiction
Administration
- PO, IM, IV, topical
- PCA
PCA
“Patient Controlled Analgesia”
Smaller doses that can be given more frequently that stabilize pain more
Analgesic Agents
Opioids (narcotics); non-opiods (non-narcotics); NSAIDs, others
Opioid Analgesics
Narcotics
- All considered “controlled substances”
- From the opium poppy plant
- Multiple opioid receptors: mu, kappa, sigma, delta, epsilon
- Endorphins: (endogenous morphine) natural internal mechanism of pain control
Controlled Substances
Dr. must write the order, no refills
Opioid Receptors are?
- Mu
- Kappa
- Sigma
- Delta
- Epsilon
Endogenous Morphine would be considered
A ‘Runner’s High”
Opioid Agonists
Narcotics
Fall under the category of Opioid Analgesics
Opioid Agonists mechanism of action?
- Achieve beneficial effects by their actions on the CNS
- Also act outside the CNS, which is where unwanted effects occur
Opioid Agonists indications?
- Alleviate sever to moderate pain (top of the charts, strongest)
- Cough suppressant - codeine, hydrocodone
- Antidiarrheal preparations (prescribe the drug for its side effect)
Opioid Agonists contraindications?
- Allergy
- Severe asthma, respiratory insufficiency
- Conditions involving elevated intracranial pressure (ICP)
- Pregnancy
This drug decreases breathing
ICP - watch neuro signs
LOC will be down already and opioids decrease LOC