Pain

Question 1

4 common myths about pain

Answer 1

+ Pain increases as we age 
+ pain as a psychiatric issue made up in the patient’s head
+ taking opioid pain meds will lead to drug addiction in most individuals
+ addiction is the most serious adverse effect

Question 2

What two parts of the nervous system make up an integrated pathway for pain

Answer 2

CNS and PNS

Question 3

Where are pain receptors found

Answer 3

The peripheral and plates of afferent neurons

Question 4

What are nociceptors

Answer 4

Afferent neurons, place where sensation of peripheral pain begins

Question 5

What three things are considered noxious stimulus to Causing pain

Answer 5

+Mechanical stimuli
+ thermal stimuli
+ hormonal stimuli (prostaglandins)

Question 6

Two types of nociceptors

Answer 6

+ A-Delta fibers: Small & fast traveling myelinated
+ C fibers: Slow unmyelinated

Question 7

What influences pain

Answer 7

+ Physical component
+ emotional component
+ Inhibitory substances such as endogenous opioids, serotonin, norepinephrine

Question 8

What are some non-pharmacological pain management techniques

Answer 8

+ Relaxation
+ guided imagery
+ positive self talk
+ music destruction
+ exercise
+ massage

Question 9

What are three impacts from unrelieved/Unresolved pain in the body

Answer 9

+ Physiologic impact
+ quality of life impact
+ financial impact

Question 10

Types of pharmacologic pain relief for mild to moderate pain

Answer 10

+ NSAIDs (Aspirin, ibuprofen, Aleve)
+ para aminophenols (acetominophen)

Question 11

What is the maximum daily dose for acetaminophen

Answer 11

3000 mg a day for chronic use

Question 12

What are the different controlled substance schedules, explain

Answer 12

+ schedule I – heroin LSD: high potential for abuse
+ Scheduled II - high potential for abuse: opioid analgesics like morphine
+ Schedule III – moderate abuse potential: Tylenol with Codeine, ketamine, anabolic steroids
+ Schedule IV - low potential for abuse: muscle relaxants, anticonvulsants, sedatives, Xanax/Valium/Ambien
Schedule V – limited potential for abuse: anti-diarrheal, antitussives with small amounts of my contacts

Question 13

Classifications of narcotic analgesics (3)

Answer 13

+ Opioid agonist/narcotic agonist: Opium derivatives, used to relieve pain without causing loss of consciousness
+ opioid antagonist/narcotic antagonist: Not pain meds, used to reverse actions – example naloxone
+ opioid agonist antagonist

Question 14

Pharmacotherapeutic of morphine

Answer 14

Treats moderate to severe acute and chronic pain - pain associated with MI

Question 15

Pharmacokinetics Of morphine

Answer 15

No subcut injections, morphine is irritating to suck a tissue

Question 16

Adverse effects of morphine

Answer 16

+ Lightheadedness, dizzy, confusion, sedation, hypotension , and/V, constipation
+ respiratory depression

Question 17

Precautions for using morphine

Answer 17

+ Elderly, acute/severe asthma
+ no ceiling effect – titrate slowly

Question 18

Contra indications of morphine

Answer 18

Severe respiratory conditions, respiratory depression

Question 19

How do you maximize therapeutic effects when treating pain

Answer 19

Assess pain prior to entering therapy:
+ P – provoking factor
+ Q – quality
+ R – radiate/relief
+ S – severity
+ T – timing, how long has it lasted, constant, intermittent?

Question 20

How do you minimize adverse effects from pain treatments

Answer 20

+ Frequent ongoing assessments
+ PRN – best if dosed routinely to ensure constant blood levels
+ Narcan - antidote
+ Using pain scale

Question 21

Morphine – teaching, assessment, a valuations

Answer 21

+ Teach the purpose of the therapy
+ stress importance of reading pain accurately
+ ongoing assessments and valuations
+ assess patient’s pain by using a pain scale
+ monitor for adverse effects

Question 22

What is some CODEINE core drug knowledge

Answer 22

+ Pharmacotherapeutic‘s: treats mild to moderate pain
+ pharmacodynamics: attaches at specific opioid receptors to produce analgesia and sedation, Attaches directly on medullary cough center to depress cough reflex