Pain

Question 1

Nociceptive treatment

Answer 1

nonopioids, opioids, and adjuvant

Question 2

Neuropathic treatment

Answer 2

Adjuvant (antidepressants and anticonvulsants)

Question 3

Gate control theory

Answer 3

• 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

Question 4

Other way to decrease pain

Answer 4

Avoid anxiety-producing stimuli at the cerebral cortex (teach, reassure)

Question 5

A alpha and A beta fibers

Answer 5

large diameter nerve fibers that close the gate

Question 6

A delta fibers

Answer 6

transmit sharp, FAST pain like hitting thumb with hammer

Question 7

C fibers

Answer 7

Transmit SLOW, throbbing pain

Question 8

Threshold

Answer 8

least amount of pain one can recognize
- does not vary btwn ppl

Question 9

Pain tolerance

Answer 9

Ability to withstand pain without showing physical signs of pain
- varies between ppl and events

Question 10

Addiction

Answer 10

Obtaining drugs for psychic effects

Question 11

Tolerance

Answer 11

Drugs lose effectiveness and a bigger dose is necessary

Question 12

Dependence

Answer 12

Withdrawal symptoms start is the drug is stopped abruptly

Question 13

Gold standard for opioids

Answer 13

Morphine

Question 14

You cannot take merperidine longer than…

Answer 14

2 days

Question 15

Percocet is a combination of…

Answer 15

Acetaminophen and oxycodone

Question 16

Antidote for pain medication

Answer 16

Naloxone

Question 17

Which opioid has a ceiling effect?

Answer 17

Codeine

Question 18

SE of opioids

Answer 18

Pruritis, sedation, urinary retention, constipation (only SE pt won’t get tolerance to), respiratory depression

Question 19

How likely is respiratory depression?

Answer 19

Not very likely

Question 20

Gold standard adjuvant therapy

Answer 20

Gabapentin (anticonvulsant class)

Question 21

Nonopioid pain meds

Answer 21

NSAIDs and tylenol

Question 22

Do NSAIDs and tylenol have a ceiling effect?

Answer 22

YES

Question 23

SE of NSAIDs

Answer 23

GI upset, inc bleeding, renal problems

Question 24

How do SE differ in Cox2 inhibitors?

Answer 24

less GI upset but inc risk MI and CVA

Question 25

Drug effects of Tylenol

Answer 25

Minimal GI upset, no anti-inflammatory properties

Question 26

How does acetaminophen work?

Answer 26

Inhibit prostaglandin synthesis

Question 27

acetaminophen limit

Answer 27

4g in 24h (hepatotoxicity)

Question 28

Antidote for acetaminophen

Answer 28

Acetylcysteine