Lecture 10

Question 1

what are the 3main barriers for effective pain management

Answer 1

patient
ohysician
system

Question 2

what are the major cnp categories

Answer 2

-primary pain
-post traumatic pain
-post surgical pain
-headache
-orofacial
-musculoskeletal pain

Question 3

what are some common therapeutic goals

Answer 3

-they usuallt=y try to find the balance between palliation and rehab
-decrease pain
-increase sleep
-increase activity
-improve mood

Question 4

chronic pain is a sciernmce

Answer 4

faose it is an art that ahs voodoo and science
this is because there is not enough scientific data

Question 5

palliative therapy: the og approach what is in it

Answer 5

-pharmacotherapy
-invasive interventions
-behavoral therapy
-hands on therapy
-complementary and alternative medecine

Question 6

true or false; duloxine is a slay

Answer 6

nah it is not really a slay for osteoarthritis knee pain, it barely beats placebo

Question 7

what are the categories of meds in pain pharmacology

Answer 7

non opioids
opioids
adjuvants

Question 8

analgesic selection should bne based on pain characteristics; what is the acronym

Answer 8

OPQRST
ONSET
PROVOCATION
QUALITY
REGION AND RADIATION
SEVERITY
TIME

Question 9

examples of invasive measures

Answer 9

-trigger point injections
-nerve blocks
-spinal axis interventions

Question 10

examples of super invasibe measures

Answer 10

-periferal nerve, spinal cord and brain stimulation
-implanted spinal pump

Question 11

outcome: paliavtive therapeutic for CNCP

Answer 11

-4 year community study
increased prevalence 45.5to53.8
79% still reported pain after 4 years
-retrospectivbe study of patients with CRPS
none had recovered
I’m most only modest symptom improvement
improvement not necessarily associated with therapy

Question 12

when was thje cancer act passed and what was its goal

Answer 12

1971
massive func=ding for cancer palliation but not prevention
-the hope was that in 2000 cancer mortality would decrease by 50%

Question 13

why was cancer act a flop

Answer 13

-death rate in the is dropped by 5% from 1950s to 2006
-palliation is effective for some cancers, it still ranks behind early detection and risk factor modification in its potential to reduce cancer mortality

Question 14

similarities between cancer and chronmic pain

Answer 14

-high prevalence
-multi factorial etiologies
-multityue of palliative therapeutic approaches
-although frequently beneficial most current approaches have so far failed to change the outcome

Question 15

the future of cncp prevention

Answer 15

-identify enviromental cobntributions
-phenotype and genotype patients at risk
-explore preventive analgesia

Question 16

can you immunize people aginst cncp

Answer 16

yeah with post herpetic neuralgia

Question 17

immunization against cncp: shing;es

Answer 17

-400 00 over 60
-median followup time of >3
-earlyt vaccination resulted in
reduced incidence of HZ by 51.3%
reduced burden of illness by 61.1%
reduced incidence of PHN by 66.5%

Question 18

self pain control: training

Answer 18

-following frm huided training
-humans could learn how to control activation of rostral anterior cingulate cortex
-in chronic pain patients; training resulted in a significant pain reduction (64%MPQ and 44% VAS