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Pharm > Mod 10 - Pain Meds > Flashcards

Mod 10 - Pain Meds Flashcards

1
Q

where does pain occur

A

where there is tissue damage

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2
Q

what are nociceptors

A

nerve endings that selectively respond to painful stimuli and send pain signals to the brain and spinal cord. they are barely present in internal organs

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3
Q

what is the pain pathway

A

nociceptor to the spinal cord to the hypothalamus to the cerebral cortex

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4
Q

what is the pain signal transmitted to the brain through

A

A-delta and C fibres

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5
Q

what is the dorsal horn used for

A

relay station from the A-delta and C fibers

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6
Q

what does the thalamus do

A

relay station for sensory stimuli

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7
Q

where is pain percieved

A

cerebral cortex

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8
Q

what is endogenous analgesia

A

CNS suppression of pain signals by opioid peptides interacting with opioid receptors to inhibit perception and transmission of pain signals (endorphins, enkephalins, dynorphins)

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9
Q

describe acute pain

A

sudden start
known cause (injury, surgery)
gets better as body heals
less than 3 months

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10
Q

describe chronic pain

A

last longer than 6 months
causes by disease or condition (injury, treatment, inflammation) or unknown
can continue after healed
some have no cause
can have tense muscles, limited ability, lack of energy, appetite changes, MH problems, interruption of daily life

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11
Q

Pain nursing process: assessment

A

what are you giving and why

ask OPQRSTTU, faces

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12
Q

Pain nursing process: implementation

A 
5 rights
allergies
best route at this time
right med for pain scale
rule of thumb: use least invasive anticpated
anticipate SE
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13
Q

Pain nursing process: evaluation

A

dec. in pain 30 mins after IV, 60 mins after oral
not gone investigate other modailites (aromatherapy, repositioning, hot/cold, music)
adverse effect of opioids - respiratory depression, RR and pulse ox check

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14
Q

what are opioid analgesics perscribed for

A

mod-severe pain

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15
Q

why is morphine at the top of the ladder

A

no celing effect so higher the dose, higher the level of anesthesia

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16
Q

patient controlled analgesia

A

push button to release, lockout to prevent OD (hydromorphone, morphine, fentanyl)

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17
Q

Concerns with morphine and what is the guideline

A
  1. determine when to initiate or continue opioids for chronic pain
  2. opioid selection, dosage, duration, follow-up, discontinuation
  3. considerations for follow up and discontinuation of opioid therapy
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18
Q

what are the components of the experience of pain

A
  • emotional response
  • learned experience (esp. w/ chronic pain) -> what it was like before influences how you deal with pain now
  • cultural factors
  • individual tolerance (gender) ->question if they’re having pain after what should be a painful experience? check their body language
  • placebo effect -> if you believe it will work, it works better
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19
Q

how many times stronger than morphine is fentanyl

A

100x

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20
Q

how many times more stronger than morphine is hydromorphone

A

5-7x more potent

21
Q

what is the most common route for pain meds and why

A

oral, b/c consistent, noninvasive, can take at home

22
Q

what route is most likely used for palative

A

transdermal but it is hard to manage and manipulate

23
Q

morphine class

A

opioid agonist

24
Q

morphine types

A

morphine IR and morphine contin (extended release)

25
Q

morphine uses

A

severe pain

26
Q

morphine action

A
  • binds to opioid receptors in the CNS and stimulates a response
  • alters our perception of pain with generalized CNS depression and increases our tolerance
  • interferes with processing pain impulses
27
Q

morphine OE

A

respiratory depression, sedation, constipation, urinary retention, nausea/vomiting

28
Q

morphine considerations

A

know RR before giving and if its <10 breaths stop and think, give laxatives/stool softeners, antiemetics if needed, nalaoxone= antidote, can lead to dependance, watch concurrent use of other CNS depressants, assess LOC and BM, extended release lasts 12 hrs and takes longer to work

29
Q

what is the purpose of using a pain scale

A

assess pain before and after giving meds and to evaluate your care

30
Q

has 7/10 pain what to give? both at once?

A

can give a short acting and long acting morphine at once bc the short action can be given every 4 hours and the long acting wont start working until 12 hours after administration. give short acting until the long acting kicks in and then stop giving short acting

  • base dose off of what they were getting before, if first time start LOW
  • reassess in 30 mins with oral meds,
31
Q

ondansetron class

A

antiemetic (serotonin antagonist)

32
Q

ondansetron uses

A

nausea/vomiting associated with chemo, post-op, pregnancy

33
Q

ondansetron action

A

blocks serotonin in the GI tract (vagus nerve), CTZ, VC (CNS)

34
Q

ondansetron O/E

A

CNS manipulation - headache, dizziness, fatigue

GI (vagus nerve) - constipation, diarrhea, upset

35
Q

ondansetron considerations

A

monitor for SS if on other serotonin medications, assess nausea/vomiting and BM, drowsiness, PO or injection route, can cause QT prolongation

36
Q

naloxone class

A

opioid antagonist

37
Q

naloxone action

A

attach to opioid receptors to block a response (initiating a pain response)

38
Q

naloxone OE

A

tremors, drowsiness, sweating, dec RR, HTN, nausea/vomiting

39
Q

naloxone considerations

A

may cause withdrawal, repeated doses may be required, parentally or inhaled route

40
Q

physical dependence def

A

A condition in which a person takes a drug over time, and unpleasant physical symptoms occur if the drug is suddenly stopped or taken in smaller doses.

41
Q

psychological dependence def

A

e emotional and mental processes that are associated with the development of, and recovery from, a substance use disorder or process addiction

42
Q

tolerance def

A

person’s reduced reaction to a drug following its repeated use. need a larger dose to make the same effects as a smaller dose once did

43
Q

addiction def

A

a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences. need to drug to function

44
Q

Docusate class

A

stool softener

45
Q

Docusate uses

A

constipation

46
Q

Docusate action

A

facilitates the movement of water and fats into the stool to make it soft and improve regularity of BMs

47
Q

Docusate OE

A

diarrhea, cramps

48
Q

Docusate considerations

A

BM within 12-72hr, stomach cramps

Pharm (9 decks)

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