Chapter 10 Analgesic Drugs Flashcards by Lisa Guerino

What is the term used for a pain killing drug that relieves pain without causing loss of consciousness?

Analgesic drugs

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Opioids are Analgesic drugs and are used for what level of pain?

moderate to severe pain

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What does NSAIDS stand for?

Non Steroidal Anti-inflammatory drugs

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Pain results from stimulation of sensory nerve fibers called ____________

nociceptors

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Nociceptors transmit pain signals from various body regions to where?
(2 places closely related)

spinal cord and brain

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What is the level of stimulus needed to produce the perception of pain called?

Pain Threshold

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Define Pain tolerance

the amount of pain a person can endure without it interfering with normal function

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What type of pain has a sudden onset and usually subsides once it’s treated?
(Acute or Chronic?)

Acute Pain

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What type of pain is persistent and recurring, can last weeks, months even years and is difficult to treat?

Chronic Pain

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List the 10 Classifications of pain
(hint: letters they start with: 
S
S
V
V
C
C
D
R
N
P

Somatic
Superficial
Visceral
Vascular
Cancer
Central
Deep
Referred
Neuropathic
Phantom

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The Gate Theory uses the analogy of a gate to describe what?

how impulses from damaged tissues are sensed in the brain
(the gates open and all the pain transmissions move from the injury site to the brain then there will be nociception which is causes perception of the pain

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What are most of the pain management strategies focused on as far as the Gate theory?

their focus is on medicine that’s purpose is to “close the gate”, blocking signals that would reach the brain and have it acknowledge the pain

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List the substances released when tissue injury occurs.

5 of them

Bradykinin
Histamine
Potassium
Prostaglandins
Serotonin

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What do the (5) substances that are released when tissue injury occurs, do to start the pain process?

they stimulate nerve endings

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What is Bradykinin?

it’s function

a vasodilator

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How is pain transmitted, meaning how does pain stimulus from the site of an injury travel?

pain stimulus travels along Afferent (sensory) Peripheral fibers up the spinal cord and to the brain

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What are the 2 types of fibers that conduct painful stimuli?

A-delta Fibers; large, fast, myelinated fibers for
sharp, localized, intense pain, & detect
intensity of that pain
C-fibers; slow, small, unmyelinated fibers for poorly
localized, burning, and persistent pain

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In Pain transmission, what is the point of spinal cord entry, “the gate”?

Dorsal horn

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If the “Gate” closes and no impulses are transmitted to higher centers of the brain, what does this mean?

there is no pain perception

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Activation of which fibers closes the gate?

A- delta fibers (large diameter)

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Activation of which fibers opens the gate?

C-fibers (small diameter)

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When tissue injury occurs, Histamine is released. What is histamine’s function in this situation?

dilates small blood vessels and increases capillary permeability.
Also causes redness and swelling at the site of injury

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Which of the substances that are released from cells in response to tissue injury, is a major intracellular cation

potassium

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Surgeries, burns, GI Bleed, etc, any situation like this where there is tissue damage causes what to happen to cells?

causes cells to break and release substances

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Where are prostaglandins found?

in every tissue and organ

Prostaglandins can cause both ____________ or ________ of the vascular smooth muscle depending on the receptor

constriction or dilation

Prostaglandins cause aggregation of _________

platelets

Prostaglandins are also pain sensitizers that enhance pain impulse that travels to the brain. true or false

true

Which of the substances that are released upon tissue damage from the damaged cells, is the one that is a neurotransmitter and is mostly associated with the feeling of well-being?

Serotonin

Which of the 5 substances that is released when a cell breaks from tissue damage, is the substance that helps alleviate the feeling of pain, soothes you?

Serotonin

A pain stimulus travels along Afferent (sensory) peripheral fibers to the _____________ tract

Spinothalamic Tract

Where do the fast, myelinated A-delta fibers and the slow, unmyelinated C fibers enter, and where are they going?

enter spinal cord, travel up to the brain

Where specifically is the point of spinal cord entry, the "gate"? (hint: it's a horn)

dorsal horn

If we close the "gate", we stop the impulses from getting to the higher centers of the brain where they are __________.

perceived | if we stop the impulses from reaching these higher brain centers then there is no pain perception

Activation of which fibers opens the gate and allows impulse transmission to the brain (pain perception)?

small diameter C fibers

The response from the brain telling the body how to react to pain is which step in the Pain Transmission process?

The final step

Impulses from the brain to the body, telling it how to react to pain, are carried away from the brain on what specific kind of nerves?

Efferent nerves | away from the brain

During pain transmission, many substances may be released from the brain or spinal cord that can either increase or decrease the perception of the painful stimulus. What are they called

neurochemical mediators

What are often targets for pain medication?

neurochemical mediators

What is a PCA? | can be given epidural or IV( hint: this is found in hospital setting)

Patient Controlled Analgesic

Define Basal Rate

the rate of continuous supply of some chemical

What is often the standard that we use when measuring pain?

WHO (world health organization) | WHO Three-Step Analgesic Ladder

what level of pain does the bottom of the WHO ladder represent? What is it treated with

mild pain | treated with over the counter pain meds

what pain level does the middle step on the WHO ladder represent? what is it treated with?

Moderate pain | Middle grade opioids(pain killers) like codiene

What pain level does the top of the WHO ladder represent? | What is it treated with?

moderate to severe pain | strong opioid such as morphine

Adjuvants do what?

assist primary drugs in relieving pain

NSAIDS, Antidepressants, Anticonvulsants, and Corticosteroids are all _________ (used to assist primary drugs in relieving pain)

Adjuvants

Xanax or valum are used as Adjuvants to help calm patients down sometimes as well. true or false?

true

List the prototypes of opioids/opioids that She listed specifically because they may be mentioned in the exam. (there are 5 of them) (STUDY THESE)

* codiene sulfate * morphine sulfate * oxycodone * fentanyl * naloxone

List the 3 Opioid Analgesics classifications based on their actions. (not as difficult as it seems)

* Agonist * Partial Agonist * Antagonist

What is the main use of an Opioid?

alleviate moderate to severe pain | also often given with adjuvant meds, example: NSAIDS

List three other indications of opioid analgesics

* Cough Center Suppression (ex: bronchitis, they give codiene) * Treat Diarrhea * Balanced Anesthesia

``` This is a list of contraindications to what type of medication/drug? - known drug allergy - severe asthma USE WITH EXTREME CAUTION IF: - Respiratory insufficiency - elevated intracranial pressure - Morbid obesity - Sleep apnea - Paralytic ileus ```

Opioid Analgesic Contraindications

What is the most serious adverse effect of Opioid Analgesics?

CNS Depression | leads to respiratory depression

List some adverse effects from an Opioid Analgesic

- Euphoria - Nausea + Vomitting - Urinary retention - diaphoresis (sweating) - constipation - itching

Opioid tolerance and physical dependence are expected with long-term opioid treatment and should not be confused with psychologic dependence (addiction). true or false

true

When is a dependency on an opioid considered a psychologic dependence?

when there's a pattern of compulsive drug use characterized by continued cravings for opioids for reasons other than pain relief

Naloxone (Narcan) and Naltrexone (Revia) are used for partial reversal to opioid -induced respir. depression. How do they work?

Bind to opiate receptors, prevent a response to the drug

What technically is acetaminophen (tylenol)?

non-opioid analgesic | (often used in combo with many opioid products

What does overdosing on acetaminophen cause?

hepatic necrosis (hepatotoxicity)

Max daily dose of tylenol (acetaminophen) for healthy adults?

4000 mg/day | 2,000 mg for elderly or those with liver disease