Ch 23 Severe Pain Flashcards

1
Q

Where are pain receptors found

A

On the peripheral end plates of afferent neurons

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2
Q

How is the emotional response to the physical stimulus of pain produced

A

By stimulation of the limbic system

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3
Q

Nociceptive pain

A

Is caused by activation of the delta and C nociceptors in response to painful stimuli, such as an injury

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4
Q

Neuropathic pain

A

Is the term used to represent pain in which the underlying pathology is abnormal processing of stimuli in the peripheral or CNS

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5
Q

What is the prototype narcotic analgesic

A

Morphine

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6
Q

What are the pharmacokinetics of morphine

A

Metabolized in the liver
Onset 15-30 min
Duration 3-7 hours

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7
Q

What are adverse effects of morphine

A
Respiratory depression 
Apnea
Respiratory distress
Circulatory depression
Cardiac arrest
Shock and coma
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8
Q

What drugs are considered mild narcotic agonists

A

Codeine
Hydrocodone
Propoxyphene

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9
Q

What is the prototype mild narcotic agonists

A

Codeine

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10
Q

What are mild narcotic agonists used for

A

Mild to moderate pain

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11
Q

What are contraindications of codeine

A

NOT GIVEN WITH OTHER NARCOTICS

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12
Q

What are adverse effects of codeine

A
Drowsiness
Sedation
Dry mouth
Nausea 
Vomiting 
Constipation
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13
Q

What are drug interactions of codeine

A
Antihistamines
Phenothiazines 
Barbituates
TCAs
Cimetidine 
And alcohol
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14
Q

How can you minimize adverse effects of codeine

A

Do not administer to patients who need to cough to clear airway
Provide for pt safety
Assess respiratory function prior to administration

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15
Q

What does codeine do

A

It acts directly on the medullary cough center to depress the cough reflex
A pt with chest tubes would be unable to cough and deep breathe to facilitate lung expansion.

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16
Q

What is the term used to describe the phenomena assoc with the initiation of a pain signal

A

Transduction

17
Q

What are narcotic agonist- antagonist?

A

Some narcotic analgesics have mixed opioid effects, being an agonist at some receptors and an antagonist at others

18
Q

What is the prototype narcotic agonist- antagonist

A

Pentazocine ( Talwin)

19
Q

What are the Pharmacotherapeutics of pentazocine ( Talwin)?

A

Agonist to control pain

20
Q

What are contraindications of pentacocine

A

Hypersensitivity

Use precaution with respiratory conditions

21
Q

What are adverse effects of pentacocine

A

Nausea, vomiting, dizziness, or lightheadness, respiratory depression, and euphoria.

22
Q

What are drug interactions of pentazocine

A

Alcohol and CNS depressants

23
Q

What should the nurse assess for when administering pentazocine

A

Contraindications and hepatic disease

24
Q

What is the antidote for pentazocine

A

Naloxone

25
Q

How can you monitor the the effects of pentazocine

A

Monitor motor control
Sedation
Pain
Adequate pain control should be achieved without adverse effects

26
Q

How does chronic liver disease affect pentazocine

A

It decreases metabolism of pentazocine