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MuE, Mtm, Ipc > PAD > Flashcards

PAD Flashcards

1
Q

How is pain assessed for patients who are able to communicate and patients who are unable to communicate?

A

M

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2
Q

What are the goals of pain control medications (or analgesics)?

A

K

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3
Q

Optional) What is multimodal analgesia?

A

J

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4
Q

What is Analgosedation (analgesia-first or analgesia-based)?

A

J

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5
Q

What are the considerations when selecting opioid analgesics in critically ill patients?

A

K

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6
Q

Patients receiving mechanical ventilation

A

V

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7
Q

For patients who are extubated

A

F

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8
Q

Patients with renal and/or hepatic insufficiency

A

C

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9
Q

Patients with severe multiorgan failure

A

F

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10
Q

Patients with hemodynamic instability

A

F

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11
Q

Patients with bronchospasm

A

F

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12
Q

Patients requiring frequent neurologic assessments

A

M

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13
Q

Patients requiring intermittent bolus opioid doses rather than an opioid infusion

A

J

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14
Q

requiring preemptive analgesia before a painful procedure

A

F

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15
Q

What are the consideration when selecting nonopioid analgesics in critically ill patients?

A

L

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16
Q

Patients with fever without hepatic insufficiency

A

V

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17
Q

Patients with severe burn or postoperative pain inadequately controlled with opioids

A

V

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18
Q

Patients with tolerance, withdrawal, or hyperalgesia after opioid therapy

A

K

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19
Q

Patients with moderate acute pain and fever

A

J

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20
Q

Patients with neuropathic pain (e.g., Guillain-Barré syndrome, diabetic peripheral neuropathy, spinal cord injury, postherpetic neuralgia, fibromyalgia)

A

F

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21
Q

Prevention of development of chronic pain syndromes

A

K

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22
Q

visual analog scale (VAS)

A

F

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23
Q

numeric rating scale (NRS)

A

V

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24
Q

Behavioral Pain Scale

A

F

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25
Q

Critical Care Pain Observation Tool.

A

F

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26
Q

provide optimal patient comfort.

A

G

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27
Q

Attenuation of adverse physiologic responses to pain (eg, hyper metabolism, increased oxygen consumption, hyper coagulability, and alterations in immune function)

A

G

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28
Q

Prevention of development of chronic pain syndromes.

A

J

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29
Q

Control of anxiety and agitation, particularly in intubated patients

A

J

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30
Q

combination of opioid and nonopioid analgesics, neuraxial or peripheral nerve blocks, nonpharmacologic treatments, and/or sedative agents 4.

A

K

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31
Q

pain is assessed and treated, usually with an opioid, prior to administering a sedative

A

U

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32
Q

opioid is used instead of a sedative to reach the sedation goal.

A

Y

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33
Q

fentanyl, morphine, or hydromorphone

A

K

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34
Q

intermittent bolus dosing of IV fentanyl, morphine, or hydromorphone

A

J

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35
Q

remifentanil

A

J

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36
Q

IV acetaminophen

A

O

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37
Q

Ketamine

A

K

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38
Q

Fentanyl

A

D

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39
Q

Hydromorphone

A

D

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40
Q

Morphine

A

D

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41
Q

Remifentanil

A

E

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42
Q

Acetaminophen

A

E

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43
Q

Ketorolac

A

F

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44
Q

Ibuprofen

A

R

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45
Q

Gabapentin

A

R

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46
Q

Pregabalin

A

E

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47
Q

Propofol

A

E

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48
Q

Ketamine

A

E

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49
Q

Dexmedetomidine

A

R

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50
Q

Midazolam

A

R

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51
Q

Lorazepam

A

R

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52
Q

Diazepam

A

E

53
Q

Haloperidol

A

E

54
Q

Olanzapine

A

E

55
Q

Quetiapine

A

E

56
Q

Ziprasidone

A

E

57
Q

Effects of sedative drugs

A

E

58
Q

Opoid analgesic
Anxiolysis

Hypnosis

Amnesia

Analgesia

A

O

59
Q

Anxiolysis

Hypnosis

Amnesia

Analgesia
Benzodiazepines

A

F

60
Q

Anxiolysis

Hypnosis

Amnesia

Analgesia
Dexmedetomidine

A

D

61
Q

Anxiolysis

Hypnosis

Amnesia

Analgesia
Haloperidol

A

D

62
Q

Anxiolysis

Hypnosis

Amnesia

Analgesia
Propofol

A

F

63
Q

What are the non-pharmacological interventions that can be used for managing distress before initiation of sedative-analgesic agent (i.e., pre-initiation)?

A

U

64
Q

What are the sedative-analgesic medications that are commonly used in the ICU (i.e., initiation)?

A

U

65
Q

For distress due to dyspnea or pain

A

U

66
Q

For distress due to delirium

A

K

67
Q

For agitation due to stress or anxiety

A

I

68
Q

For patients who are intubated and mechanically ventilated and not able to clearly communicate the source of agitation

A

I

69
Q

How should the sedative-analgesic therapies be monitored following initiation (maintenance)?

A

N

70
Q

Optional) What is bispectral index (BIS) monitoring?

A

J

71
Q

What is the risk of withdrawal symptoms following discontinuation of sedative-analgesic therapies?

A

M

72
Q

frequent communication with the patient,

A

U

73
Q

regular caregiver visits,

A

H

74
Q

establishment of normal sleep cycles

A

U

75
Q

cognitive-behavioral therapies

A

J

76
Q

use of …… rather than benzodiazepines in cardiac surgery patients

A

.

77
Q

propofol or dexmedetomidine rather than
……… in other surgical and medical patients

A

.

78
Q

pain scale

A

F

79
Q

sedation scale,

A

G

80
Q

delirium scale

A

G

81
Q

Benzodiazepine withdrawal symptoms

A

J

82
Q

Opiate withdrawal symptoms

A

H

83
Q

agitation, confusion, anxiety, tremors, tachycardia, hypertension, and fever.

A

K

84
Q

agitation, anxiety, confusion, rhinorrhea, lacrimation, diaphoresis, mydriasis, piloerection, stomach cramps, diarrhea, tremor,
nausea, vomiting, chills, tachycardia, hypertension, and fever.

A

K

85
Q

1 to 2 mcg/kg

A

D

86
Q

0.5 to 2 mg

A

Dd

87
Q

2 to 10 mg

A

F

88
Q

1.5 mcg/kg

A

D

89
Q

50 to 300 mcg/hr

A

C

90
Q

0.5 to 3 mg/hr

A

F

91
Q

2 to 30 mg/hr

A

F

92
Q

0.5 to 15 mcg/kg/hour

A

F

93
Q

Metabolized hepatically by 3A4 to inactive

A

K

94
Q

Highly lipophilic parent drug accumulates in adipose

A

J

95
Q

Chest wall rigidity may occur with higher dose

A

K

96
Q

good choice for analgesia for most critically ill patients.

A

J

97
Q

Non-CYP metabolism (glucuronidation) may be an advantage for patients receiving drugs intermittent and/or that significantly alter CYP3A4 metabolism and thereby interact with fentanyl.

A

K

98
Q

Potentially neurotoxic (excitatory) metabolite(s) may accumulate in
hepatic and/or renal dysfunction . ◊

A

L

99
Q

Non- CYP metabolism (glucuronidation)

A

M

100
Q

Histamine release and vagally mediated venodilation, hypotension, and bradycardia can be significant .

A

K

101
Q

Analgesic alternative to fentanyl or hydromorphone where preload reduction and myocardial depressive effects are desirable or tolerable

A

J

102
Q

Avoid in patients with advanced or decompensated liver disease with renal impairment due to risk of accumulation of neurotoxic metabolite.

A

J

103
Q

used for palliative purposes.

A

K

104
Q

Cleared by nonspecific plasma esterases to inactive metabolites

A

,

105
Q

Anticipate pain and discomfort upon abrupt cessation

A

K

106
Q

Glycine excipient may accumulate in renal impairment . ◊

A

J

107
Q

alternative to fentanyl for patients requiring frequent neurologic assessments or those with multiorgan failure.

A

K

108
Q

Lacks dependence and tolerance of
Opoids

A

J

109
Q

Lacks antiplatelet effect and gastrointestinal toxicity of NSAIDs.

A

U

110
Q

Lacks significant anti-inflammatory effect.

A

K

111
Q

Can cause hepatotoxicity in chronic or acute overdose.

A

K

112
Q

When hepatic dysfunction is significant, consider avoiding or reducing dose (eg, ≤2 g/day total).

A

K

113
Q

Effective anti-inflammatory.

A

J

114
Q

Reversibly inhibits platelet functioning

A

K

115
Q

May alter cardioprotective effect of aspirin.

A

K

116
Q

Avoid in renal impairment, gastrointestinal bleeding, platelet dysfunction, ischemic heart disease, heart failure, reduced cardiac output, hypovolemic state, asthma, or cirrhosis.

A

J

117
Q

Useful adjunct to other analgesics for treatment of neuropathic and postoperative pain or dysesthesias in patients who can be treated with enteral medication. Dose adjustment needed for renal

A

K

118
Q

decreases intracranial pressure, lowers cerebral metabolism, controls intractable seizures, and may reduce shivering

A

I

119
Q

Adverse effects include hypotension, bradycardia, respiratory depression, decreased myocardial contractility, elevated triglycerides, peripheral injection site pain, and rarely, propofol infusion syndrome

A

J

120
Q

Sympathetic stimulation (ie, increased HR and myocardial oxygen demand, elevated intracranial pressure and systemic blood pressure)

A

K

121
Q

alternate choice for postsurgical pain management, severe agitation, or as an adjunctive analgesic in patients with severe refractory pain in clinical settings where increased myocardial oxygen demand and sympathetic tone are tolerable.

A

K

122
Q

Can be used in non-mechanically ventilated ICU patients

A

K

123
Q

It is the only IV benzodiazepine that is not delivered in propylene glycol.

A

L

124
Q

Propylene glycol solvent may accumulate with prolonged use or high dosing causing metabolic acidosis and end- organ dysfunction

A

M

125
Q

Hepatically metabolized by CYP2C19 and 3A4 to active metabolites

A

K

126
Q

Rapid onset with potent sedative and muscle- relaxant effects.

A

K

127
Q

Seldom used for sedation of critically ill patients.

A

K

128
Q

Complex hepatic metabolism includes CYP3A4 and 2D6 transformations.

A

L

MuE, Mtm, Ipc (13 decks)

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