Intro to CNS + Pain management Flashcards
why are infants more sensitive to pain medications
BBB not fully developed - limits passage to brain
tolerance is described as ….
more drug needed over time to get the same response
physical dependence
abrupt cessation of the medication will produce withdrawal effects (symptoms when drug not in system)
what type of drugs would be given for mild pain (1-3)
non-opioids (aspirin, acetaminophen, NSAIDs, adjuvants)
what type of drugs would be given for moderate pain (4-7)?
moderate to strong opioids
what type of drugs would be given for severe pain (7-10)?
strong opioids
what is an adjuvant?
used for off use pain management
used at every level of pain
examples of adjuvants
amitriptyline, gabapentin, lidocaine patch
describe equianalgesic dosing
giving a dose of something that is equivalent in pain-relieving ability to another dose
what is the preferred route for chronic or consistent pain? why?
ORAL - prevents high and lows
onset of oral pain medication
30 mins
why is IM administration not recommended for pain control
variable absorption rates
what is the onset for IV pain medications?
within minutes (5 for most)
PCA is not great for which patients
those with dementia, sedated
what is used to monitor patients with PCA? why?
end tidal CO2 - more accurate and “real time” than O2 sats - alarm for hypoventilation!
which pain medication is contraindicated in post-op patients?
fentanyl patch (b/c their pain should be decreasing over time)
what conditions can increase absorption of fentanyl?
heat - heating pad, fever, hot tub, heating blanket
which drug should NOT be used with opioid naive patients as it comes on SUPER INTENSE + SUPER FAST?
fentanyl (Actiq) - buccal “lolli”
what type of dosing is preferred for chronic and cx pain + 1st 24 hours post op to create a steady state in the blood and better pain control?
around the clock dosing (ATC)
