Final Exam Flashcards - Pain & Migraine

Question 1

Acute vs. Chronic Pain

Answer 1

• Acute pain is triggered by an injury, burn, infection, etc.
• Chronic pain can persist for years

Question 2

Opioids MOA

Answer 2

-Bind to receptors located in the dorsal route of the spinal chord; brainstem; thalamus, hypothalamus, and limbic system

Question 3

Classification of Opioids

Answer 3

• Classified based on their action at the opioid receptor
• Agonists
• Partial Agonists
• Antagonist
• Mixed Agonists/Antagonists

Question 4

Opioid Agonists

Answer 4

-Activate mu, kappa, and delta receptors and produce analgesia

Question 5

Opioid Agonist ADR’s

Answer 5

• N/V
• Sedation
• Dizziness
• Respiratory depression
• Constipation
• Tolerance and dependence

Question 6

Opioid Partial Agonists

Answer 6

-Cause incomplete activation of the opioid receptor, producing less than maximum response

Question 7

Opioid Antagonists

Answer 7

• Bind to opioid receptor but do not activate it (can reverse the effects of an agonist)
• Indicated for reversal of respiratory depression caused by opioid use/abuse

Question 8

Opioid Mixed Agonists/Antagonists

Answer 8

• Agonist activity is exhibited when the patient has had no recent exposure to an opioid agonist
• If the patient is currently taking an opioid agonist, the mixed agonist/antagonist will produce antagonist activity

Question 9

NSAIDS

Answer 9

• Have analgesic, anti-inflammatory, and antipyretic properties
• Non-selective COX inhibitors
• Inhibit both COX-1 and COX-2

Question 10

NSAIDS ADR’s

Answer 10

• Hepatotoxicity (ketorolac)
• Agranulocytosis (indomethacin, flurbiprofen)
• salicylism (aspirin)
• N/V
• GI bleeding
• Ulceration
• Dizziness
• Fluid retention
• Increased BP

Question 11

Acetaminophen

Answer 11

• Inhibits COX-3 in the brain

- Antipyretic and analgesic, but not anti-inflammatory

Question 12

Acetaminophen ADR’s

Answer 12

-Hepatotoxicity

Question 13

Neuropathic Pain

Answer 13

-Pain associated with a nerve injury caused by trauma, infection, or chronic disease

Question 14

Drug Treatment of Neuropathic Pain

Answer 14

-Often responds poorly to NSAIDS or opioids

• Commonly used agents are:
• Antidepressants (TCAs and SNRIs)
• Anticonvulsants
• Local anesthetics
• Topical Capsaicin

Question 15

Antidepressants Used for Neuropathic Pain

Answer 15

• TCAs are first choice

- SNRIs are also commonly used, but they are much less effective

Question 16

Anti-seizure Drugs Used for Neuropathic Pain

Answer 16

• gabapentin
• pregabalin
• carbamazepine
• topiramate

Question 17

Local Anesthetics Used to Treat Neuropathic Pain

Answer 17

• lidocaine
• xylocaine
• topical capsaicin

Question 18

Primary Headaches

Answer 18

• Migraine headaches
• Tension headaches
• Cluster headaches

Question 19

Migraine Symptoms

Answer 19

• Severe throbbing pain
• Nausea
• Photophobia
• Phonophobia
• Physical activity worsens symptoms

Question 20

Drug Treatment For Migraines

Answer 20

• Analgesics
• Ergot Alkaloids
• Serotonin agonists (Triptans)

Question 21

Analgesics For Migraine

Answer 21

• ASA
• Acetaminophen
• NSAIDS
• Opioids
• Barbiturate
• ASA or acetaminophen combined with codeine

Question 22

Ergot Alkaloids

Answer 22

• Contraindicated in pregnancy

- should not be used within 24 hours of triptans

Question 23

Triptans

Answer 23

• Stimulate vasoconstriction
• Most widely prescribed for migraines
• Administered at first sign of an impending migraine or during an acute attack to lessen symptoms

Question 24

Migraine Treatment ADR’s

Answer 24

• Pain, tightness and burning at injection site
• Dizziness
• Nausea
• Hot flashes
• Dry mouth
• Fatigue