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Pharm 201 > Chapter 18 > Flashcards

Chapter 18 Flashcards

1
Q

What to assess for pain

A

grimace, crying, shaking, splinting
assess location, duration, intensity, quality (dull, sharp), what brings it on, what decreases it, effects on ADL
need to provide coping strategies

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2
Q

Physiologic consequences of unrelieved pain

A

increased HR, increased SNS, adrenaline
decreased sleep, mobility, strength,
decreased immune reactions and can lead to disease

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3
Q

Psychologic consequences of unrelieved pain

A 
depression
anxiety
decreased QOL
dependence
suffering
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4
Q

Acute pain

A

abrupt onset

short duration

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5
Q

Chronic pain

A

3-6 months
can indicate a life threatening underlying disease like cancer
acute pain without treatment becomes chronic pain

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6
Q

Intractable pain

A

no cure at this time

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7
Q

Nociceptor Pain

A

Due to injury to tissues
Sharp, localized
Dull, throbbing, aching

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8
Q

Neuropathic Pain

A

Due to injury to nerves

Burning, shooting, numbing

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9
Q

Cutaneous pain

A

skin, paper cut

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10
Q

Somatic pain

A

caused by trauma to ligament, tendon, bones, blood vessels, nerves

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11
Q

Visceral pain

A

associated with an organ
stretched tissues, ischemia, muscle spasm- pain receptors deep in the abdominal cavity or brain or thorax
(appendicitis, kidney stone, pancreatitis, cancer, heart attack)

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12
Q

Radiating pain

A

extends beyond painful affected area (jaw from MI)

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13
Q

Referred pain

A

felt in remote part of the body

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14
Q

Neuropathic pain

A

along nerve fibers: diabetic neuropathy, painful fingers & toes, plantar fasceitis

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15
Q

Phantom pain

A

can be reduced by treating pain before amputation using neuropathic pain medication Gabapentin or pregambin (lyrica)

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16
Q

Transmission of pain

A

Nociceptor stimulated by noxious stimuli
Spinal cord receives pain impulse through
A∂ fibersand C fibers

17
Q

Pharmacological Techniques

A

Analgesics
CNS level (Opioids)
Narcotic

18
Q

Analgesics

A

meds used to relieve pain

NSAIDS

19
Q

CNS level (Opioids)

A

natural or synthetic Obtained from opium from poppy plant with >20 chemicals
Opium consists of 9%-14% morphine & 0.8%-2.5% codeine (natural opiates)

20
Q

Narcotic

A

refers to morphine like drugs that produce analgesia & CNS depression

21
Q

Opioid agonist drugs

A

interact with 6 opioid receptors: mu, kappa, sigma, delta, epsilon

22
Q

Opioid antagonist drugs

A

block receptors

Naloxone (Narcan) inhibits mu & kappa receptors

23
Q

Mixed Opioid Agonist-Antagonist

A

Pentazocine (Talwin) mixed agonist/antagonist (analgesia w/o withdrawal s/s)

24
Q

Opioid drug route

A

IV PO or SQ

no IM

25
Q

Opioid (Narcotic) Analgesic mechanism of action

A

bind to opioid receptors throughout CNS & peripheral tissues

26
Q

Opioid (Narcotic) Analgesic use

A

to relieve moderate to severe pain; some used for anesthesia
Suppress cough reflex
Slow motility of GI tract
May increase intracranial pressure

27
Q

Opioid (Narcotic) Analgesic monitoring

A

severe heart, liver or kidney disease, respiratory disease or seizures, ELDERLY
VS, LFTs, BUN, Cr, GFR

caution in pregnancy: Cross blood-brain barrier, placental barriers and enter breast milk

28
Q

Fentanyl ½ life

A

1-2hr

29
Q

Dilaudid ½ life

A

2-4 hr

30
Q

Morphine ½ life

A

3-4hr

31
Q

Meperidine ½ life

A

2.5-4hr

32
Q

Phenergan

A

must be diluted in 10mL of NS and given over 2 minutes

can cause phlebitis

33
Q

Adverse Effects of Opioids

A

Respiratory depression
Increased ICP
Constipation, nausea, urinary retention, depression
Orthostatic hypotension

34
Q

Opioid Toxicity

A

Pinpoint pupils ↓ BP ↓ O2 sat Coma

Priority action is to open airway, give oxygen and give opioid antagonist ASAP

35
Q

Addiction

A

craving substances for mood altering effect rather than pain relief – continue to use the substance despite harmful or negative consequences

36
Q

Tolerance

A

need for more medication to control pain over a period of time
occurs within 2 weeks

37
Q

Dependence

A

physiological need for the drug the body needs the drug to feel OK-abrupt withdrawal results in S&S

38
Q

Pseudoaddiction

A

iatrogenic syndrome of abnormal behaviors developing as a direct consequence of inadequate pain management

Pharm 201 (24 decks)

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