Chapter 9 Pain Flashcards
How do you get the most information about a patient’s pain?
ask patient to explain using descriptive words.
What types of meds are given as adjuvants? What are some of the most common ones?
corticosteroids, antidepressants, antiseizure drugs, GABA receptor agonists, alpha adrenergic agonists, local anesthetics
What is the purpose of adjuvant meds? How do you know they have been effective?
a
What is the focus (goal) of treatment for chronic pain?
Control pain to the extent possible, focus on enhancing function and quality of life.
What do you do if a patient on a PCA is waking up every night with pain?
Consider switching to a different medication in the PCA.
What pain meds should rarely ever be used, especially for chronic pain?
Darvon, Darvocet
When do you choose to give a rapid-acting IV opioid?
Breakthrough pain
What is the best medication to give an elderly patient with complaints of mild pain? Why?
Tylenol, less effect on GI
When should you withhold pain medicine in a terminal patient with severe pain?
Never
What concerns should you have about OTC pain meds?
GI problems, bleeding, analgesic ceiling, drug interactions, side effects
What is breakthrough pain and how do you manage it?
Transient, mild to severe pain that occurs in pts whose baseline persistent pain is otherwise mild to moderate and fairly well controlled. Peak 3-5 minutes, can last 30 minutes
What is the focus (goal) of treatment for chronic pain?
a
What do you do if a patient on a PCA is waking up every night with pain?
a
What pain meds should rarely ever be used, especially for chronic pain?
a
When do you choose to give a rapid-acting IV opioid?
a
What is the best medication to give an elderly patient with complaints of mild pain? Why?
a
When should you withhold pain medicine in a terminal patient with severe pain?
a
What concerns should you have about OTC pain meds?
a
What is breakthrough pain and how do you manage it?
a
Adjuvants: Corticosteroids
(Prednisone, Dexamethasone) Inflammation. best for cancer pain, spinal cord compression, inflammatory joint pain, many side effects, don’t give with NSAIDS
Adjuvants: Antidepressants
(Elavil, Cymbalta) Neuropathic pain. Increases serotonin and norepinephrine, promotes sleep, don’t give if hx of seizures or cardiac disease, bad for older adults (long half life), many side effects,
Adjuvants: Antiseizure Drugs
(Lamictal, Neurotonin, Lyrica) Neuropathic pain, Multimodal therapy for acute pain, Fibromyalagia. Affect peripheral nerves and CNS
Adjuvants: GABA Receptor Agonists
(Baclofen) Nueropathic pain, Muscle spasms. Inhibits pain transmission, used for muscle spasms, best used intrathecally
Adjuvants: Alpha Adrenergic Agonists
(Clonidine, Zanaflex) Used for chronic headaches, neuropathic pain
Adjuvants: Local Anesthetics
(Lidocaine, Zostrix) Interrupts transmission of pain signals to the brain, works for types of neuropathic pain
