Chapter 18: Drugs for the Control of Pain Flashcards
What is Nociceptive pain?
pain d/t injury to tissues
What are two types of nociceptive pain?
- somatic: sharp sensation (localized
- Visceral: Dull, throbbing, aching (form internal organ inflammation or damage
What is Neuropathic Pain?
- dt injury to nerves
- burning, shooting, numbing
What are some examples of Neuropathic pain?
- carpal tunnel syndrom
- Degenerative disk disease
- Diabetic retinopathy
- interactable cancer pain
- phantom limb pain
- Postsurgical pain
- sciatica
What are some nonpharmacologic therapies for pain?
- acupuncture
- biofeedback
- massage
- heat or cold
- meditation/prayer
- relaxation therapy
- art or music
- guided imagery
- chiropractic manipulation
- hypnosis
- physical therapy
- therapeutic physical touch
- TENS
- natural agents applied to skin, producing warming sensation
What treatment is available for intractable cancer pain?
- radiation or chemo
- Relieving nerve stimulation
- surgery
- nerve block
What are Opioids?
Natural or synthetic morphine-like substances responsible for reducing moderate to servere pain
which opioid receptors are most important for pain management?
mu and kappa receptors
What do Opioid agonist drugs do?
stimulate mu and kappa receptors
What are some examples of opioid agonist drugs?
Morphine, OxyContin, Percocet
What do opioid antagonist drugs do?
- block mu and kappa receptors
- reverse symptoms of addition, toxicity, and OD
What is an example of an opioid antagonist drug?
Narcan
What do Opioids with mixed agonist-antagonist activity do?
- stimulate opioid receptor, thus causing analgesia
- withdrawal symptoms and side effects not as intesnse as those of opioid agnosits
What is an example of a mixed agonist-antagonist?
pentazocin
What is the treatment for Opioid dependence?
- switch from IV and inhalation opioids to methadone
- may be needed for many months to years
- does not cure but avoids withdrawal symptoms
- allows pt to be productive
What are some newer treatments for opioid dependence?
- Early treatment: buprenophrine: mixed opioid agonist-antagonist
- admin sublinqual or transdermal
- Later maintenance: bunavail, suboxone, and zubsolv contain bothe buprenorphine and naloxone
What are 4 steps for opioid therapy in the role of a nurse?
- Assess potential for opioid dependency
- Assist with activity
- monitor urine output for retention
- monitor patients bowel habits for constipation
What are non-opioid analgesics used for?
- used for fever, inflammation, and analgesia
- used for mild or moderate pain associated with inflammation
What are examples of non-opioid analgesics?
- NSAIDs
- acetaminophen
- a few centrally acting drugs
What is the role of the Nurse for nonopiod analgesics?
- monitor pts condition and provide education
- assessment for hypersensitivity, bleeding disorders
- assessment for gastric ulcers, severe renal/hepatic disease, pregnancy
- obtain lab tests on renal liver function
- pain assessment
What is the prototype drug for NSAIDs
ibuprofen
what is the MOA of ibuprofen
to inhibit cyclooxygenase and prvent formation of prostaglandins
What is the primary use for iburprofen?
for mild or moderate pain and to reduce inflammation
What are the adverse effects of NSAIDs
GI upset, acute renal failure
