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Pain > Intro to Pain > Flashcards

Intro to Pain Flashcards

1
Q

What information do we need to collect from the patient in regards to pain?

A
  1. Type
  2. Intensity
  3. Source
  4. Location
  5. Duration
  6. Time course
  7. Alleviating factors
  8. Aggravating factors
  9. Effect on daily living
  10. Effect on QOL
  11. Effect on functional capacity
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2
Q

What are the goals of assessment?

A
  1. Characterize pain
  2. Evaluate comorbidities
  3. Develop treatment plan
  4. Set goals for pain tx
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3
Q

What is the biggest take away point from the pain assessment tools we have?

A

No single test is better than the others. The most important point is that they provide more information about pain than just a number

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4
Q

What are the physical consequences of untreated pain?

A
  1. decreased mobility
  2. decreased sleep
  3. decreased concentration
  4. anorexia
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5
Q

What are the psychological consequences of untreated pain?

A
  1. depression
  2. feelings of loss
  3. fear of missing out
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6
Q

What are the social consequences of untreated pain?

A
  1. isolation
  2. dependence on others
  3. impaired relationships
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7
Q

What are the economic consequences of untreated pain?

A
  1. decreased income

2. increased healthcare costs

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8
Q

What are the endocrine consequences of untreated pain?

A

altered released of hormones, like cortisol, resulting in weight loss/gain, fever, and shock

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9
Q

What are the cardiovascular consequences of untreated pain?

A

increased HR, BP, oxygen demand, and hypercoagulation

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10
Q

What are the respiratory consequences of untreated pain?

A

decreased air flow which increases the risk of atelectasis or pneumonia

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11
Q

What are the immune consequences of untreated pain?

A

decreased immunity

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12
Q

What are the GI consequences of untreated pain?

A

decreased motility and gastric emptying

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13
Q

What are the musculoskeletal consequences of untreated pain?

A

muscle spasms resulting in immobility and weakness

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14
Q

Define pain

A

an unpleasant sensory and emotional experience associated with the actual or potential tissue damage

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15
Q

What is pain the combination of?

A

a destructive process and an emotional experience

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16
Q

What is nociceptive pain?

A

acute pain that is protective or physiologic pain

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17
Q

What are the two subclasses of nociceptive pain?

A

somatic and visceral

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18
Q

What is visceral pain?

A

pain associated with an organ

19
Q

What is referred pain?

A

when pain from an organ is felt in another location. This is due to the decreased quantity of nociceptors involved

20
Q

What is somatic pain

A

pain arising from skin, bone, joint, or connective tissue (localized)

21
Q

What is neuropathic pain?

A

Pain arising from a compromised nervous system

22
Q

What is acute pain?

A

Nociceptive pain that occurs for 30 days or less

23
Q

What is chronic pain?

A

longer than 30 days

24
Q

What are the 4 steps of pain?

A
  1. transduction
  2. transmission
  3. perception
  4. modulation
25
Q

What is transduction?

A

Stimulation of nociceptors in the periphery

26
Q

What can nociceptors distinguish between?

A

noxious stimuli vs. innocuous stimuli

27
Q

What can nociceptors be triggered by?

A

mechanical, thermal, and chemical stimuli

28
Q

What internal substances trigger nociceptors?

A

bradykinins, prostaglandins, histamine, interleukins, tumor necrosis factor, serotonin, and substance P

29
Q

What is substance P?

A

an amino acid chain that causes vasodilation and allows for the recruitment of inflammatory mediators and mast cells

30
Q

What are the three parts of a nerve ending?

A

primary sensory afferents, motor neurons, and sympathetic postganglionic neurons

31
Q

What do A-beta fibers respond to?

A

touch or moving

32
Q

What do A-delta and C fibers respond to?

A

intense pain to skin, deep tissue and visceral structures

33
Q

What sends action potentials through afferent nerve fibers?

A

voltage gated sodium channels

34
Q

What is sensitization?

A

the threshold to activate nociceptors is lowered

35
Q

What pain medicines target transduction?

A

topical pain meds

36
Q

When and where does transmission take place?

A

When there is a synapse on the dorsal horn of the spinal cord

37
Q

Which pain meds mostly target transmission?

A

non-opioid pain meds

38
Q

What is perception?

A

process of pain becoming a conscious experience in the brain

39
Q

What role does the somatosensory cortex play in pain

A

location, intensity, and quality

40
Q

What role does the cingulate gyrus play in pain?

A

emotional dimension of pain. Origination of fear of pain

41
Q

Where are opioid receptors located?

A

the descending pathway

42
Q

What are the clinician barriers to pain management?

A
  1. lack of training
  2. lack of assessment skills
  3. lack of attention to pt
  4. difficult to assess
  5. hesitancy to prescribe
43
Q

What are the patient barriers to pain management?

A
  1. reluctance to report
  2. negative stigma
  3. poor compliance
  4. adverse effects
  5. difficulty getting meds
44
Q

What is the role of the pharmacist in pain management?

A
  1. controlled substance med rec
  2. opioid stewardship
  3. dosing conversions
  4. med counseling
  5. monitoring med therapy
  6. developing policies
  7. providing education

Pain (3 decks)

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