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Pharmacology: Central Nervous System Drugs > Analgesics > Flashcards

Analgesics Flashcards

0
Q

addiction

A

a chronic neurobiologic disease whose development is influenced by genetic, psychosocial, and environmental factors (same as psychological dependence)

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1
Q

acute pain

A

pain that is sudden in onset, usually subsides when treated, and typically occurs over less than a 6-week period

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2
Q

adjuvant analgesic drugs

A

drugs that are added for combined therapy with a primary drug and may have additive or independent analgesic properties, or both

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3
Q

agonist

A

a substance that binds to a receptor and causes a response

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4
Q

agonists-antagonists

A

substances that bind to a receptor and cause a partial response that is not as strong as that caused by an agonist (also known as a partial agonists)

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5
Q

analgesic ceiling effect

A

what occurs when a given pain drug no longer effectively controls a patient’s pain despite the administration of the highest safe dosages

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6
Q

analgesics

A

medications that relieve pain without causing loss of consciousness (sometimes referred to as painkillers)

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7
Q

antagonist

A

pain that occurs between doses of pain medication

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8
Q

breakthrough pain

A

pain that occurs between doses of pain medication

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9
Q

cancer pain

A

pain resulting from any of a variety of causes related to cancer and/or the metastasis of cancer

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10
Q

central pain

A

pain resulting from any disorder that causes central nervous system damage

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11
Q

chronic pain

A

persistent or recurring pain that is often difficult to treat; includes any pain lasting longer than 3 to 6 months, pain lasting longer than 1 month after healing of an acute injury, or pain that accompanies a non-healing tissue injury

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12
Q

deep pain

A

pain that occurs in tissues below skin level; opposite of superficial pain

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13
Q

gate theory

A

the most well-described theory of pain transmission and pain relief; it uses a gate model to explain how impulses from damaged tissues are sensed in the brain

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14
Q

narcotics

A

a term originally applied to drugs that produce insensibility or stupor, especially the opioids (e.g. morphine, heroin); currently used to refer to any medically used controlled substances and in legal settings to refer to any illicit or “street” drug

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15
Q

neuropathic pain

A

pain that results from a disturbance of function or pathologic change in a nerve

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16
Q

nociception

A

processing of pain signals in the brain that gives rise to the feelings of pain

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17
Q

nociceptors

A

a subclass of sensory nerves (A and C fibres) that transmit pain signals to the central nervous system from other body parts

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18
Q

non-opioid analgesics

A

analgesics that are not classified as opioids

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19
Q

non-steroidal antiinflammatory drugs (NSAIDs)

A

a large, chemically diverse group of drugs that are analgesics and also possess antiinflammatory and antipyretic activity but are not corticosteroids

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20
Q

opioid analgesics

A

synthetic drugs that bind to opiate receptors to relieve pain

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21
Q

opioid naive

A

describes patients who are receiving opioid analgesics for the first time and who therefore are not accustomed to their effects

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22
Q

opioid tolerance

A

a normal physiologic condition that results from long-term opioid use, in which larger doses of opioids are required to maintain the same level of analgesia and in which abrupt discontinuation of the drug results in withdrawal symptoms (same as physical dependence)

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23
Q

opioid tolerant

A

the opposite of opioid naïve; describes patients who have been receiving opioid analgesics (legally or otherwise) for a period of time (1 week or longer) and who are at greater risk of opioid withdrawal syndrome upon sudden discontinuation

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24
Q

opioid withdrawal

A

the signs and symptoms associated with abstinence from or withdrawal of an opioid analgesic when the body has become physically dependent on the substance

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25
Q

pain

A

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

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26
Q

pain threshold

A

the level of a stimulus that results in the sensation of pain

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27
Q

pain tolerance

A

the amount of pain a patient can endure without it’s interfering with normal function

28
Q

partial agonist

A

a drug that binds to a receptor and causes a response that is less than that caused by a full agonist (same as agonist-antagonist)

29
Q

phantom pain

A

pain experienced in the area of a body part that has been surgically or traumatically removed

30
Q

physical dependence

A

a condition in which a patient takes a drug over a period of time and unpleasant physical symptoms (withdrawal symptoms) occur if the drug is stopped abruptly or smaller doses are given; the physical adaption of the body to the presence of an opioid or other additive substance

31
Q

psychologic dependence

A

a pattern of compulsive use of opioids or any other additive substance characterised by a continuous craving for the substance and the need to use it for effects other than pain relief (also called addiction)

32
Q

referred pain

A

pain occurring in an area away from the organ of origin

33
Q

somatic pain

A

pain that originates from skeletal muscles, ligaments, or joints

34
Q

special pain situations

A

the general term for pain control situations that are complex and whose treatment typically involves multiple medications, various health car personnel, and non-pharmacologic therapeutic modalities (e.g. massage, chiropractic care, surgery)

35
Q

superficial pain

A

pain that originates from the skin or mucous membranes; opposite of deep pain

36
Q

synergistic effects

A

drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone (e.g. 1 + 1 is greater than 2)

37
Q

tolerance

A

the general term for a state in which repetitive exposure to a given drug, over time, induces changes in drug receptors that reduce the drug’s effects (same as physical dependence)

38
Q

vascular pain

A

pain that results from pathology of the vascular or peri vascular tissues

39
Q

visceral pain

A

pain that originates from organs or smooth muscles

40
Q

World Health Organisation (WHO)

A

an international body of health care professionals, including clinicians and epidemiologists among many others, that studies and responds to health needs and trends worldwide

41
Q

non-pharmacologic treatment options for pain

A

acupuncture, acupressure, comfort measures, counselling measures, distraction, hot or cold packs, hypnosis, massage, meditation, music therapy, physical therapy, relaxation, surgery, therapeutic baths, therapeutic communication, therapeutic touch, yoga

42
Q

conditions that alter pain tolerance: lowered pain threshold

A

anger, anxiety, depression, discomfort, fear, isolation, chronic pain, sleeplessness, tiredness

43
Q

conditions that alter pain tolerance: raised pain threshold

A

diversion, empathy, rest, sympathy, medications (analgesics, antianxiety drugs, antidepressants)

44
Q

acute versus chronic pain: acute

A

onset: sudden (minutes to hours); usually sharp, localised; physiologic response (SNS: tachycardia, sweating, pallor, increased blood pressure)
duration: limited (has an end)
examples: myocardial infarction, appendicitis, dental procedures, kidney stones, surgical procedures

45
Q

acute versus chronic pain: chronic

A

onset: slow (days to months); long duration; dull, persistent aching
duration: persistent or recurring (endless)
examples: arthritis, cancer, lower back pain, peripheral neuropathy

46
Q

potential opioid adverse effects

A

constipation, nausea and vomiting, sedation and mental clouding, respiratory depression, subacute overdose

47
Q

potential opioid adverse effects: constipation

A

opioids decrease gastrointestinal (GI) tract peristalsis due to CNS depression with subsequent constipation as an adverse effect; stool becomes excessively dehydrated because it remains in the GI tract longer

48
Q

opioid adverse effects management: constipation

A

increased intake of fluids, stool softeners (e.g. docusate sodium), stimulants (e.g. bisacodyl or senna); agents (e.g. lactulose, sorbitol, and polyethylene glycol (Miralax); bulk-forming laxatives (e.g. psyllium) for which increased fluid intake is necessary to avoid fecal impactions or bowel obstructions

49
Q

potential opioid adverse effects: nausea and vomiting

A

opioids decrease GI tract peristalsis and some stimulate the vomiting centre in the CNS

50
Q

opioid adverse effects management: nausea and vomiting

A

antiemetics (e.g. phenothiazines)

51
Q

potential opioid adverse effects: sedation and mental clouding

A

any change in mental status should be evaluated to ensure causes other than drug-related CNS depression are ruled out

52
Q

opioid adverse effects management: sedation and mental clouding

A

persistent drug-related sedation may be managed with a decrease in the dosage of opioid or change in drug used; prescriber may also order various CNS stimulants

53
Q

potential opioid adverse effects: respiratory depression

A

long-term opioid use is generally associated with tolerance to respiratory depression

54
Q

opioid adverse effects management: respiratory depression

A

for severe respiratory depression, opioid antagonists (e.g. naloxone) may be used to improve respiratory status, and if they’re titrated in small amounts, the respiratory depression may be reversed without analgesia reversal

55
Q

potential opioid adverse effects: subacute overdose

A

may progress slowly (over hours to days), with somnolence and respiratory depression

56
Q

opioid adverse effects management: subacute overdose

A

often, holding one or two doses of an opioid analgesic is enough to judge if mental and respiratory depression is associated with the opioid; if improvement with this measure, opioid dosage is often decreased by 25%

57
Q

potential opioid adverse effects: other

A

dry mouth, urinary retention, pruritis, myoclonus, dysphoria, euphoria, sleep disturbances, sexual dysfunction, and inappropriate secretion of antidiuretic hormone

58
Q

opioid adverse effects management: other

A

ongoing assessment for each adverse effect so that appropriate measure can be implemented (e.g. sucking of sugar-free candy or use of artificial saliva drops or gum for dry mouth; use of diphenhydramine for pruritis)

59
Q

opioid-induced adverse effects by body system: cardiovascular

A

hypotension, flushing, bradycardia

60
Q

opioid-induced adverse effects by body system: central nervous

A

sedation, disorientation, euphoria, lightheadedness, dysphoria

61
Q

opioid-induced adverse effects by body system: gastrointestinal

A

nausea, vomiting, constipation, biliary tract spasm

62
Q

opioid-induced adverse effects by body system: genitourinary

A

urinary retention

63
Q

opioid-induced adverse effects by body system: integumentary

A

itching, rash, wheal formation

64
Q

opioid-induced adverse effects by body system: respiratory

A

respiratory depression, possible aggravation of asthma

65
Q

opioid antagonists (reversal drugs): naloxone (IV) [Narcan]

A

raised or lowered blood pressure, dysrhythmias, pulmonary oedema, withdrawal

66
Q

opioid antagonists (reversal drugs): naltrexone (PO) [ReVia]

A

nervousness, headache, nausea, vomiting, pulmonary oedema, withdrawal

67
Q

analgesic drugs

A

acetaminophen, codeine sulfate, fentanyl, lidocaine (transdermal), meperidine hydrochloride, methadone hydrochloride, morphine sulfate, naloxone hydrochloride, naltrexone hydrochloride, oxycodone hydrochloride, tramadol hydrochloride

Pharmacology: Central Nervous System Drugs (8 decks)

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