Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

anaesthetics > essential pain management > Flashcards

essential pain management Flashcards

1
Q

what is pain

A

an unpleasant sensory and emotional experience associated with or resembling that associated with acute or potential tissue damage or described in terms of such damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

benefits of treating pain: physical

A

improved sleep
better appetite
fewer medical complications
better mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

benefits of treating pain: psychological

A

reduced suffering

less depression, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

benefits of treating pain: for society

A

lower health costs e.g. shorter hospital stay

able to contribute to community

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

classification of pain: acute pain

A

recent onset, probable limited duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

classification of pain: chronic pain

A

> 3 months

often no identifiable cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

classification of pain: cancer pain

A

progressive

may be mixture of acute and chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

classification of pain: nociceptive pain

A

obvious tissue injury or illness
aka physiological or inflammatory pain
protective function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

classification of pain: neuropathic pain

A

nervous system damage or abnormality

does not have protective function - pain ongoing after original injury (if there has been one)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pain physiology: periphery

A

tissue injury that results in release of chemicals - prostaglandins, substance p

stimulation of nociceptors

signals travel in A-delta or C fibres to spinal cord (dorsal root ganglion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pain physiology: spinal cord

A

dorsal horn is first relay station

second nerve travels up opposite site of spinal cord into thalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pain physiology: brain

A

thalamus is second relay station

connections to many parts of brain - cortex, limbic system, brainstem

pain perception occurs in cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pain physiology: modulation

A

descending pathway from brain to dorsal horn

usually decreases pain signal - neurotransmitters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

neuropathic pain pathological mechanisms

A

increased receptor numbers - enhance pain signal and keeps it going

abnormal sensitisation of nerves - peripheral, central

chemical changes in dorsal horn

loss of normal inhibitory modulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

simple analgesics

A

paracetamol (acetaminophen)

NSAIDs - ibuprofen, diclofenac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

opioids

A

weak: codeine, tramadol
strong: morphine, oxycofone, fentanyl

potential for addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

treatments: periphery

A

non-drug: rest, ice, elevation

NSAIDs - reduce amount of prostaglandins

local anaesthetics - reduce nociceptive afferent triggering

18
Q

treatments: spinal cord

A

non-drug: acupuncture, massage, TENS

local anaesthetics: epidural, nerve blockade

opioids

ketamine (modulates pain signal in descending pathways)

19
Q

treatments; brain

A

non-drug: psychological

drug:
paracetamol
opioids
amitriptyline 
clonidine
20
Q

paracetamol: advantages

A

cheap, safe
can be given orally, rectally or IV
good for mild pain (itself) or mod-severe (used w other drugs)

21
Q

paracetamol: disadvantages

A

liver damage in overdose

max dose related to patient weight

22
Q

NSAIDs advantages

A

cheap, gen safe

good for nociceptive pain

23
Q

NSAIDs disadvantages

A

GI and renal (reduced renal blood flow) side effects plus bronchospasm in some patients with asthma

24
Q

codeine advantages

A

cheap
sage
good for mild-moderate acute nociceptive pain

25
Q

codeine disadvantages

A

constipation

not good for neuropathic pain

26
Q

tramadol advantages

A

less respiratory depression
can be used with opioids and simple analgesics
less constipating

27
Q

tramadol disadvantages

A

nausea + vomiting

controlled drug

28
Q

morphine advantages

A

cheap, generally safe
can be given orally, IV, IM, SC, PR, intrathecally

effective if given regulaly

29
Q

morphine disadvantages

A

constipation
resp depression in high dose
controlled drug
addiction/avoidance due to fear of addiction

30
Q

amitriptyline advantages

A

cheap, safe in low dose
good for neuropathic pain
also treats depression, poor sleep

31
Q

amitriptyline disadvantages

A

anti-cholinergic side effects (e.g. glaucoma, urinary retention)

long term use may be linked with cognitive decline and dementia

32
Q

pain assessment

A 
verbal rating score
numerical rating score
visual analogue scale
smiling faces
abbey pain scale (for confused patients) 
functional assessments
33
Q

WHO pain ladder: step one

A

non-opioids - NSAIDs or paracetamol

34
Q

WHO pain ladder: step 2

A

mild opioids (e.g. codeine) with or without non-opioids

35
Q

WHO pain ladder: step 3

A

strong opioids (e.g. morphine) with or without non-opioids

36
Q

WHO pain ladder: mild pain

A

bottom rung of ladder

37
Q

WHO pain ladder: moderate pain

A

bottom and middle rungs

38
Q

WHO pain ladder: severe pain

A

bottom and top rungs

39
Q

WHO pain ladder: as pain resolves

A

move from top to middle rung
continue bottom rung

lastly,, stop NSAIDs first then paracetamol

40
Q

RAT approach to pain management

A

recognise pain
assess pain - severity, type, other factors
treat - non-drug, drugs

41
Q

drugs for neuropathic pain

A

amitryptiline
gabapentin
duloxetine

anaesthetics (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions