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PathoPharm > Lilley Ch 10 (analgesics) > Flashcards

Lilley Ch 10 (analgesics) Flashcards

1
Q

Medications that relieve pain without causing loss of consciousness

A

analgesics

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2
Q

what 5 things influence pain

A 
age
culture
race
spirituality 
personal experiences
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3
Q

level of stimulus needed to produce the perception of pain

A

pain threshold

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4
Q

what receptors play significant role in pain sensation

A

mu opioid receptors

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5
Q

when the number of mu opioid receptors is high, is pain diminished or more painful

A

diminished

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6
Q

when the number of mu opioid receptors is low, is pain diminished or more painful

A

more painful

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7
Q

classification of pain: skeletal muscles, ligaments, joints

A

somatic

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8
Q

classification of pain: organs and smooth muscles

A

visceral

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9
Q

classification of pain: skin & mucous membranes

A

superficial

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10
Q

classification of pain: tissues below skin level

A

deep

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11
Q

classification of pain: vascular or perivascular tissues (thought to account for a large percentage of migraine headaches)

A

vascular

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12
Q

classification of pain: visceral nerve fibers at the level of spinal cord close to fibers that supply specific subq tissues in the body

A

referred

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13
Q

classification of pain: damage to peripheral or central nervous system

A

neuropathic

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14
Q

classification of pain: occurs in a body part that has been removed

A

phantom

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15
Q

classification of pain: acute, chronic or both. Pressure from tumor mass against nerves, organs or tissues

A

cancer

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16
Q

classification of pain: tumors, trauma, inflammation, or disease affecting CNS tissues

A

central

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17
Q

describe the gate theory of pain transmission

A

small c fibers contribute to nociception, opening the gate for pain to reach the brain
large a fibers inhibit nociception and close the gate

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18
Q

how soon should you reassess pain after giving an IV med and PO med

A

IV: 15 min
PO: 60 min

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19
Q

what substances are released as a result of tissue injury that stimulate the pain process (5)

A
  • bradykinin
  • histamine
  • potassium
  • prostaglandins
  • serotonin
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20
Q

what are two endogenous neurotransmitters that the body produces to fight pain

A

enkephalins

endorphins

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21
Q

neurotransmitter involved in pain responses

A

Substance P

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22
Q

neurotransmitter released by the pituitary gland to block pain perception by blocking the release of Substance P

A

endorphins

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23
Q

adjuvant drugs that allow the use of smaller dosages of opioids

A

synergistic effect

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24
Q

what is PCA

A

patient controlled analgesia

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25
Q

4 examples of adjuvant drugs that assist primary drugs in relieving pain

A

NSAIDs
antidepressants
corticosteroids
anticonvulsants

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26
Q

what are the 3 categories on the 3 step ladder by WHO

A
  1. non-opioid with or without adjuvant
  2. opioid with or without nonopioid and with or without adjuvant
  3. stronger opioid with or without nonopioid and with or without adjuvant
27
Q

what are two mild agonists of opioids

A

hydrocodone

codeine

28
Q

what are six strong agonists of opioids

A 
morphine
hydromorphone
oxycodone
fentanyl
methodone
mereperidine (no longer used)
29
Q

common side effects (2) of opioids and what to treat with

A

nausea: antiemetics
constipation: stool softener or laxative

30
Q

which class of opioid analgesic is associated with with analgesic ceiling effects

A

agonist-antagonist

31
Q

what is the reversal agent (antidote) for opioid overdose

A

narcan

32
Q

what is an important contraindication for opioid use

A

severe asthma

33
Q

what are four adverse effects of opioid use

A
  • release of histamine
  • CNS depression (respiratory depression)
  • nausea and vomiting
  • urinary retention
34
Q

A common physiologic result of chronic opioid treatment; Result: larger dose is required to maintain the same level of analgesia

A

opioid tolerance

35
Q

Physiologic adaptation of the body to the presence of an opioid

A

physical dependence

36
Q

A pattern of compulsive drug use characterized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief

A

psychologic dependence

37
Q

what are five things that can cause interactions with opioid analgesics

A
  • alcohol
  • antihistamines
  • barbiturates
  • benzodiazepines
  • monoamine oxidase inhibitors
38
Q

opioid: schedule 2, ceiling effect, for chronic long-term pain management, opioid agonist

A

codeine

39
Q

opioid: schedule 2, for chronic long-term pain management, *don’t give fast, available in a patch

A

fentanyl

40
Q

opioid: schedule 2, 7x more powerful than morphine, exalgo: extended release and less abuse potential

A

dilaudid

41
Q

opioid: schedule 2, no longer used because associated with toxic levels and seizures

A

mereperidine

42
Q

opioid: schedule 2, opioid of choice for detox, long half-life (can cause unintentional overdose and death)

A

dolophine

43
Q

opioid: schedule 2, prototype for all opioid drugs, high abuse potential, embeda: newest product

A

morphine

44
Q

opioid: schedule 2, combined with acetaminophen = percocet, combined with aspirin = percodan

A

oxycodone

45
Q

oxycodone + acetaminophen =

A

percocet

46
Q

oxycodone + aspirin =

A

percodan

47
Q

hydrocodone + acetaminophen =

A

vicodin / norco

48
Q

4 examples of agonist-antagonist opioids (schedule 4, low risk of misuse/addiction)

A

buprenex
stadol
nubain
talwin

49
Q

opioid antagonist: Drug of choice for the complete or partial reversal of opioid-induced respiratory depression

A

narcan

50
Q

opioid antagonist used for alcohol and opioid addiction

A

naltrexone

51
Q

nonopioid analgesic: relieves pain and fever, blocks PG synthesis, liver toxic

A

acetaminophen (tylenol)

52
Q

max recommended daily dose for healthy adult for tylenol

A

3000 mg

53
Q

max recommended daily dose for adult with alcohol abuse for tylenol

A

2000 mg

54
Q

antidote for tylenol toxicity

A

mucomist (acetylcysteine)

55
Q

nonopioid analgesic: weak bond opioid receptor, not.a controlled substance

A

tramadol

56
Q

topical anesthetic: transdermal, max time for application: 12 hours

A

lidocaine patch

57
Q

if respiration rate is less than __ breaths per minute, you should withhold opioids

A

10-12 breaths per minute

58
Q

herbal product with antiinflammatory properties, used to treat migraine headaches, menstrual cramps, inflammation, and fever

A

feverfew

59
Q

culture that believes in the power of healers who rely strongly on the religious faith of people and often use prayer and the laying on of hands for relief of pain.

A

african american

60
Q

culture that believes in prayer, the wearing of amulets, and the use of herbs and spices to maintain health and wellness. Specific herbs are used in teas and therapies, often including religious practices, massage, and cleansings.

A

hispanic american

61
Q

culture that utilizes acupuncture, herbal remedies, yin and yang balancing, cold treatment, and moxibustion as ways to treat pain

A

chinese

62
Q

culture(s) that are often reluctant to express their pain because they believe that the pain is God’s will or is punishment for past sins

A

asian/pacific islanders

63
Q

culture that utilizes massage, the application of heat, sweat baths, herbal remedies, and being in harmony with nature as treatments for pain

A

native american

64
Q

culture in which patients are expected to express their pain openly and anticipate immediate relief, preferably through injections or intravenous drugs.

A

arab

PathoPharm (42 decks)

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