B6-017 Pain Management Flashcards
migraines, TMJ, fibromyalgia, IBS are examples of […] pain
centralized
amplification of nervous system pain
centralized
widespread pain
pain to non-painful stimuli
normal imaging and labs
centralized pain
pain that follows a distinct distribution based on injury
neuropathic
patient reports pain in dermatomal distributions
neuropathic
pain due to inflammation
nociceptive
osteoarthritis causes […] pain
nociceptive
can cause seizure, especially when coupled with anti-depressants or muscle relaxants
tramadol
weak mu agonist and serotonin reuptake inhibitor
tramadol
helps to address pain via cognitive and behavioral interventions
pain psychology
first line non-pharmacologic agent used to help pain and improve physical function
physical therapy
resolves with effective analgesic therapy and patient was not seeking care for ineffective pain relief
pseudoaddiction
respiratory depression, sedation, hypotension, bradycardia
overdose
physiologic state resulting from regular use of a drug in which an increased dosage is needed to provide relief
tolerance
state of adaptation manifested by drug signs and symptoms that can be produced by abrupt cessation, dose reduction, or antagonist administration
physical dependence
psychiatric disorder where use of a substance is characterized by loss of control, compulsive use, preoccupation, and continued use despite harm
addiction
pain that follows a distinct distribution
neuropathic
potential for respiratory depression and dose-related constipation are side effects of
opioids
important components of the physical exam for chronic pain [6]
muscle strength
sensory abnormalities
reflexes
coordination
gait
cranial nerve testing
is imaging necessary for the workup of pain?
no
imaging is often over ordered and does not necessarily correlate to pain
what type of study may be useful in the evaluation of the peripheral nervous system to guide prognosis/treatment?
EMG
most research [does/does not] support the use of opioids for chronic non-cancer pain
does not
poor drug metabolizers can accumulate what opioid?
hydrocodone
contraindicated in patients <18 due to respiratory depression/death
codeine
opioid that can lower the seizure threshold
tramadol
stronger mu opioid agonist and NE reuptake inhibitor
can increase serotonin levels
tapentadol
resolves with effective analgesic therapy
pseudoaddiction
treatment for opioid overdose
naloxone
osteoarthritis
autoimmune disorders
cancer
cause […] pain
nociceptive
diabetic neuropathy
post-herpetic neuralgia
sciatica
carpal tunnel
cause […] pain
neuropathic
pain due to inflammation or damage
nociceptive
pain due to nerve damage/entrapment
neuropathic
pain due to CNS or systemic problem
centralized
pain is well-localized, consistent effect of activity on pain
nociceptive
follows nerve distribution/dermatome
neuropathic
episodic
lancinating (stabbing)
numbness
tingling
described […] pain
neuropathic
pain is widespread and accompanied by fatigue, sleep/memory/mood difficulties
centralized
fibromyalgia
functional GI disorders
TMJ
tension headache
intersitial cystitis, bladder pain syndrome
examples of […] pain
centralized
considered first line pharmacotherapy for neuropathic pain
gabapentinoids
best initial conservative treatment of pain
helps reduce pain and improve function
physical therapy
can help to increase perception of control and self-efficacy in pain disorders
increases good health behaviors like sleep, exercise, appropriate med use
pain psychology
acupuncture and tai chi are examples of
complementary alternative medicine
