Ch 23 Severe Pain Flashcards
Where are pain receptors found
On the peripheral end plates of afferent neurons
How is the emotional response to the physical stimulus of pain produced
By stimulation of the limbic system
Nociceptive pain
Is caused by activation of the delta and C nociceptors in response to painful stimuli, such as an injury
Neuropathic pain
Is the term used to represent pain in which the underlying pathology is abnormal processing of stimuli in the peripheral or CNS
What is the prototype narcotic analgesic
Morphine
What are the pharmacokinetics of morphine
Metabolized in the liver
Onset 15-30 min
Duration 3-7 hours
What are adverse effects of morphine
Respiratory depression Apnea Respiratory distress Circulatory depression Cardiac arrest Shock and coma
What drugs are considered mild narcotic agonists
Codeine
Hydrocodone
Propoxyphene
What is the prototype mild narcotic agonists
Codeine
What are mild narcotic agonists used for
Mild to moderate pain
What are contraindications of codeine
NOT GIVEN WITH OTHER NARCOTICS
What are adverse effects of codeine
Drowsiness Sedation Dry mouth Nausea Vomiting Constipation
What are drug interactions of codeine
Antihistamines Phenothiazines Barbituates TCAs Cimetidine And alcohol
How can you minimize adverse effects of codeine
Do not administer to patients who need to cough to clear airway
Provide for pt safety
Assess respiratory function prior to administration
What does codeine do
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.
What is the term used to describe the phenomena assoc with the initiation of a pain signal
Transduction
What are narcotic agonist- antagonist?
Some narcotic analgesics have mixed opioid effects, being an agonist at some receptors and an antagonist at others
What is the prototype narcotic agonist- antagonist
Pentazocine ( Talwin)
What are the Pharmacotherapeutics of pentazocine ( Talwin)?
Agonist to control pain
What are contraindications of pentacocine
Hypersensitivity
Use precaution with respiratory conditions
What are adverse effects of pentacocine
Nausea, vomiting, dizziness, or lightheadness, respiratory depression, and euphoria.
What are drug interactions of pentazocine
Alcohol and CNS depressants
What should the nurse assess for when administering pentazocine
Contraindications and hepatic disease
What is the antidote for pentazocine
Naloxone
How can you monitor the the effects of pentazocine
Monitor motor control
Sedation
Pain
Adequate pain control should be achieved without adverse effects
How does chronic liver disease affect pentazocine
It decreases metabolism of pentazocine
