Pain Flashcards
Nociceptive treatment
nonopioids, opioids, and adjuvant
Neuropathic treatment
Adjuvant (antidepressants and anticonvulsants)
Gate control theory
- gate is at the dorsal horn of the spinal cord
- open gate causes pain feeling and response
- gate is closed by A alpha and A beta fibers being stimulated by rubbing, hot or cold sensation
Other way to decrease pain
Avoid anxiety-producing stimuli at the cerebral cortex (teach, reassure)
A alpha and A beta fibers
large diameter nerve fibers that close the gate
A delta fibers
transmit sharp, FAST pain like hitting thumb with hammer
C fibers
Transmit SLOW, throbbing pain
Threshold
least amount of pain one can recognize
- does not vary btwn ppl
Pain tolerance
Ability to withstand pain without showing physical signs of pain
- varies between ppl and events
Addiction
Obtaining drugs for psychic effects
Tolerance
Drugs lose effectiveness and a bigger dose is necessary
Dependence
Withdrawal symptoms start is the drug is stopped abruptly
Gold standard for opioids
Morphine
You cannot take merperidine longer than…
2 days
Percocet is a combination of…
Acetaminophen and oxycodone
Antidote for pain medication
Naloxone
Which opioid has a ceiling effect?
Codeine
SE of opioids
Pruritis, sedation, urinary retention, constipation (only SE pt won’t get tolerance to), respiratory depression
How likely is respiratory depression?
Not very likely
Gold standard adjuvant therapy
Gabapentin (anticonvulsant class)
Nonopioid pain meds
NSAIDs and tylenol
Do NSAIDs and tylenol have a ceiling effect?
YES
SE of NSAIDs
GI upset, inc bleeding, renal problems
How do SE differ in Cox2 inhibitors?
less GI upset but inc risk MI and CVA
Drug effects of Tylenol
Minimal GI upset, no anti-inflammatory properties
How does acetaminophen work?
Inhibit prostaglandin synthesis
acetaminophen limit
4g in 24h (hepatotoxicity)
Antidote for acetaminophen
Acetylcysteine
