Neurosensory Flashcards
Adjuvant analgesic drugs
Drugs that are added for combined therapy with a primary drug and may have additive or independent analgesic properties, or both
agonists
Substances that bind to a receptor and cause a response
Agonist–antagonists
Substances that bind to a receptor and cause a partial response that is not as strong as that caused by agonists (also known as partial agonists)
Antagonists
Substances that bind to a receptor and prevent (block) a response, resulting in inhibitory or antagonistic drug effects; also called inhibitors
Ceiling effect
The effect that occurs when a particular pain drug no longer effectively controls a patient’s pain despite the administration of the highest safe dosages.
ie. - Codeine has a ceiling amount 200-300mg/day
Breakthrough pain
pain that occurs between doses of pain medication
Gate control theory
A common and well-described theory of pain transmission and pain relief. It uses a gate model to explain how impulses from damaged tissues are sensed in the brain
Neuropathic pain
Pain that results from a disturbance of function or pathological change in a nerve
Nociception
Processing of pain signals in the brain that gives rise to the feeling of pain
Nociceptive pain
Pain that arises from mechanical, chemical, or thermal irritation of peripheral sensory nerves (e.g., after surgery or trauma or associated with degenerative processes). Two subtypes of nociceptive pain are visceral and somatic
Nociceptors
A subclass of sensory nerves (A and C fibres) that transmit pain signals to the central nervous system from other body parts
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A large, chemically diverse group of drugs that are analgesics and possess anti-inflammatory and antipyretic properties but are not corticosteroids.
Nonopioid analgesics
Analgesics that are structurally and functionally different from opioids
Pain threshold
The level of stimulus that results in the
sensation of pain
Pain tolerance
The amount of pain a patient can endure
without its interfering with normal function
Referred pain
Pain occurring in an area away from the organ
of origin
Synergistic effects
Drug interactions in which the effect of a
combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone
Vascular pain
Pain that results from pathology of the vascular or perivascular tissues.
Visceral pain
Pain that originates from internal organs or smooth muscles.
Types of analgesics
- Nonopioids including acetaminophen and aspirin and
other NSAIDs - Opioids, which are natural or synthetic drugs that either
contain or are derived from morphine (opiates) or have opiate-like effects or activities (opioids), and opioid ago- nist–antagonist drugs
older adult considerations for pain/pain management
older adult pts may be reluctant to report pain. They also may metabolize opiates at a slower rate and thus are at increased potential for adverse effects such as sedation and respiratory depression. The best rule is to begin with low dosages, re-evaluate often, and go slowly during upward titration
Opioids are not to be used with
alcohol or with other CNS depressants, unless ordered, because of worsening of the depressant effects
what SE must be promptly reported to the nurse or other health care provider
Dizziness, difficulty breathing, low blood pressure, excessive sleepiness (sedation), confusion, or loss of memory
If pain is problematic and not managed by monotherapy, a combination of a variety of medications may be needed. Other drugs that may be used include:
antianxiety drugs, sedatives, hypnotics, or anticonvulsants.
A natural alkaloid narcotic which when metabolized is the same chemical structure as morphine
codeine
A semisynthetic when combined with Acetaminophen 300mg is call Percocet
oxycodone
A synthetic often given for obstetric pain and preoperative although it produces a toxic metabolite which can cause seizures and delirium
meperidine
A synthetic opioid first used as an general anesthetic and is available in a patch for long term use
fentanyl
A natural opioid often prepared synthetically due to low plant yield. When combined with Acetaminophen and Caffeine is call Tylenol #3
codeine
This drug when combined with Asa s called Percadan
oxycodone
A synthetic opioid used for detoxification treatment for persons with addiction to opioids
methadone
For many NSAIDS a common side effect is GI symptoms including bleeding, ulceration and perforation. Which NSAID provides protection for the stomach and intestinal lining (COX1 protection).
Celecoxib
When treating severe pain associated with metastatic bone cancer, which type of pain management scheduling provides the best results?
Regular scheduled with breakthrough dosages
What is the benefit of transdermal fentanyl patches in the management of bone pain from metastatic cancer?
More analgesia for longer time periods
