Misc, Group Projects, Pain (General) Flashcards
Information Literacy is the ability to…
- know when information is needed
- find info
- evaluate info
- process info
- use info to make appropriate decisions
What checklist can be used to evaluate research sources?
C: credibility
A: accuracy
R: reasonableness
S: support
How can a resource exhibit credibility?
-created by person or organization who knows the subject and cares about its quality
How can a resource exhibit accuracy?
-source with info that is current, complete, correct
How can a resource exhibit reasonableness?
-a source that is truthful and unbiased
How can a resource exhibit support?
-a source that provides convincing evidence for the claims made; can find at least 2 other sources that support it (triangulate)
How should you communicate information to your patient?
- provide a comprehensive answer
- use language appropriate for the pt
- provide verbal and written information
- verify understanding
Patient Assistance Programs
-offered by pharm manufacturers and other organizations to provide meds at little to no cost to patients who cannot afford them; may provide discount cards
How to Find a PAP
-through state’s health department website
What might happen if drugs are improperly disposed of?
- end up in the water supply
- improperly used by others
- found by drug seekers
How can you dispose of old/unused medication?
- medicine take back programs
- proper disposal in trash
- some can be flushed
Medicine Take Back Programs
-city or county run programs that dispose of prescriptions that are no longer needed
Disposing of Medication in the Trash
- put medicine in undesirable substance like kitty litter or coffee grounds
- do not crush the pill
- place mixture in ziplock bag and throw away
- remove any personal information and drug name from container
Flushing Medications
- only certain drugs can be removed this way
- check label on bottle, ask pharmacist or check FDA website
- examples: oxycontin, morphine, percocet, dilaudid, demerol (meperidine hydrochloride)
Diabetic Peripheral Neuropathy
- affects 60-70% of pts w/ DM
- neuropathy cannot be reversed
- must manage blood glucose levels and use pharmacotherapy appropriately; lifestyle modifications
Effect of Medications for Diabetic Peripheral Neuropathy
-meds typically do not make DPN pain go away
How to Get Medicare Prescription Drug Coverage
- join a medicare drug plan
- join a medicare advantage plan (HMO or PPO) that includes prescription drug coverage
What Will a Pt Have to Pay for Medicare Drug Benefit Plan?
- costs vary depending on which drug plan pt chooses
- most drug plans charge a monthly fee that varies by plan
Ways to Lower Prescription Drug Costs
- switch to drugs that cost less: generic, OTC or less expensive brand name drugs
- national and community based programs that can help with drug costs
- many manufacturers offer Pharm Assistance Programs
When Can Someone Join A Medicare Plan?
- from 3 months before you turn 65 to 3 months after
- during the annual Medicare enrollment period
Who runs Medicare drug plans?
-insurance companies and other private companies approved by Medicare
Coverage Gap
- “donut hole”
- temporary limit on what the drug plan will cover for drugs
- coverage gap begins after you and your plan have spent a certain amount for covered drugs
Catastrophic Coverage
- kicks in once you get out of the coverage gap
- you only pay a small copay for covered drugs the rest of the year
Formulary
list of drugs covered by a Part D plan
Tier of Charges
-different levels of copays
True Out of Pocket Costs (TrOOP)
-payments that count toward the out of pocket limit that gets you out of the coverage gap and triggers catastrophic coverage
Common Pain Complaints During Pregnancy
- lower back pain
- pelvic pain
- foot and leg pain
- sciatic nerve pain
- muscle spasms and HA
ADHD Symptoms
- hyperactivity
- trouble focusing and maintaining attention
- behavior issues
Cause of ADHD
- still unknown
- one study said genetics 7-80% of ADHD risk
- other potential causes: nutrition, environment, brain injuries
JAMA APAP During Pregnancy Study
- more than 1/2 of mothers reported APAP use while pregnant
- APAP use found to increase risk of ADHD dx, use of ADHD meds, or having ADHD-like behaviors in kids at age 7
FDA Drug Safety Study on APAP During Pregnancy
- APAP pain reliever of choice during pregnancy
- no significant findings that APAP causes birth defects or other complications
Aspirin and Pregnancy
- category D
- NOT recommended for use during pregnancy
NSAIDs and Pregnancy
- acceptable during 1st and 2nd trimester (most are cat B)
- avoid in 3rd trimester (cat D) due to assoc with fetal birth defects
Non-Pharm Options for Pregnancy Pain
- chiropractic
- acupuncture
- massage
- PT
- RICE, heat, adequate hydration
What is garcinia cambogia?
- from a tropical fruit in Indonesia
- popular weight loss supplement
How does it allegedly work?
- decrease fat production
- reduce appetite
- maintain blood sugar and cholesterol levels
- HCA blocks citrate lyase (key enzyme involved in fat process)
Current Research for Garcinia Cambogia
- lacks strong support for effectiveness of HCA on weight loss
- may help short term weight loss, but effect is small and not stat. significant
- minimal evidence of harm in short term, but no long term studies done
Patient Education for Weight Loss
- weight loss can increase insulin sensitivity
- healthy lifestyle is safest way to lose weight: healthy foods, regular physical activity
Pathophys of Pain
- pain signal transmission starts at nociceptors
- nociceptors stimulated by biochemals (leukotrienes, prostaglandins)
- pain is modulated in the brain by endogenous opioid system
- endorphins and narcotic analgesics interact w/ opioid receptors in the brain
4 Types of Pain
- nociceptive
- inflammatory
- neuropathic
- functional
Nociceptive Pain
- transient pain in response to noxious stimulus at receptors in cutaneous tissue, bone, muscle etc
- prevents further damage via withdrawal reflex
Inflammatory Pain
-serves to prevent contact or movement of injured part until healing is complete
Neuropathic Pain
-spontaneous pain and hypersensitivity assoc. w/ damage to peripheral nervous system
Functional Pain
-pain sensitivity due to an abnormal processing of functioning of CNS in response to normal stimuli
5 Classifications of Pain
- acute
- chronic
- chronic malignant
- chronic nonmalignant
- neuropathic
Chronic Pain
- pain that persists beyond time of expected healing
- no useful physiologic purpose
Chronic Malignant Pain
pain assoc w/ progressive dz that is usually life threatening (eg cancer)
Chronic Nonmalignant Pain
- pain not assoc w/ life threatening dz
- lasts >6 mos beyond healing period
Why is pain undertreated?
- incorrect assumptions (“correct” amt of pain for an injury)
- incorrect attitudes (“pain builds character”)
- complexity of pain assessment
- research and training inadequate
Predictors of Inadequate Pain Management
- age
- non Caucasian
- low cognitive performance
- multiple other medications
Pain History from a Pt
- Palliative/provocative factors
- Quality
- Radiation
- Severity
- Temporal factors
How can pain be measured?
- self report and/or behavior observation tools
- tailor to pt developmental level and situation
- physiologic: HR, BP, RR, diaphoresis
- behavioral: cry, facial expression
- Faces Pain Rating scale, descriptive rating scales, numerical rating scales (0-10! not 1-10)
Principles of Effective Pain Management
- assess pain intensity and relief regularly
- respect pt preferences
- evaluate effectiveness of pain management and medication AEs
Non-pharm Therapy for Pain
- psych interventions: controlled mental imagery, relaxation training, biofeedback, psychotherapy, support groups
- PT: heat, cold, water, TENS, ultrasound, massage
