Pain

Question 1

What is nociceptive pain

Answer 1

Noxious stimuli

Just your regular old pain

Question 2

What is inflammatory pain

Answer 2

Tissue damage present

Still normal

Question 3

What is neuropathic pain

Answer 3

Damage to nervous system

Pathological

Question 4

What is functional pain

Answer 4

Abnormal response to normal stimuli

Question 5

What is chronic malignant pain

Answer 5

Associated with progressive diseases

Question 6

What is chronic non-malignant pain

Answer 6

Not life threatening disease but >6mos past healing period

Question 7

What kind of pain is acute pain

Answer 7

Nociceptive or Neuropathic

Question 8

Tx of mild pain

Answer 8

Non-opiod + adjuvant

Question 9

Tx moderate pain

Answer 9

Medium opioid + Non-opiod + adjuvant

Question 10

Tx severe pain

Answer 10

Strong opioid + Non-opiod + adjuvant

Question 11

What are the Non-opiods

Answer 11

Acetaminophen

NSAIDs

Question 12

What is the first line for low back pain and OA

Answer 12

Acetaminophen

Question 13

What is a major AE of Acetaminophen

Answer 13

Hepatotoxicity

Question 14

When are NSAIDs given

Answer 14

Inflammation pain

RA, Gout

Question 15

Do Non-opioids have a ceiling

Answer 15

Yes

Question 16

Moderate pain opioids (4-6)

Answer 16

Codeine
Hydrocodone
Oxycodone
Meperidine
Propoxyphene (cept no)
Tramadol

Question 17

Severe pain opioids (7-10)

Answer 17

Morphine
Hydromorphone
Oxymorphone
Levorphanol
Fentanyl/Sufentanil
Methadone

Question 18

Which Opioids have ceiling

Answer 18

Mixed

Question 19

What happens when you go over ceiling

Answer 19

Increased chance of AE

Question 20

What are the Mixed

Answer 20

Pentazocine
Butorphanol
Nalbuphine
Buprenorphine

Question 21

How is Pruritis/Urticaria managed

Answer 21

Hydroxyzine

Diphenhydramine

Question 22

How is constipation managed

Answer 22

Senna + Docusate

Laxative + Softener

Question 23

Why are bulk formers not good for pts with advanced disease

Answer 23

Needs lots of fluid intake

Question 24

How is N/V managed

Answer 24

May become tolerant
Hydroxyzine
Metoclopramide
Prochlorperazine

Question 25

How is Sedation managed

Answer 25

Tolerance | Methylphenidate

Question 26

How is Resp Depression managed

Answer 26

Naloxone

Question 27

Which opioid is not given via routine dosing

Answer 27

Meperidine | Mixed (due to withdrawal and psych)

Question 28

How does routine dosing work

Answer 28

Give till comfortable and give again before the effect wears off

Question 29

What is the rescue dose

Answer 29

10-20% of daily total requirement - For breakthrough pain (Fentanyl lollipop)

Question 30

When are TCAs given as adjuvants

Answer 30

Neuropathic pain Diabetic neuropathy Post-herpetic neuralgia Fibromyalgia

Question 31

What are the TCA AE

Answer 31

``` Constipation Xerostomia Blurred vision Decreased cognition Tachy Orthostatic hypotention --> falls Weight gain and sedation ```

Question 32

Which TCAs are secondary amines

Answer 32

Desipramine | Nortriptyline

Question 33

Which TCAs are tertiary amines

Answer 33

Imipramine | Amitriptyline

Question 34

Which TCAs have less AEs

Answer 34

Secondary

Question 35

How do TCAs work

Answer 35

NE/5-HT reup inhibitor | Descending inhibition of pain

Question 36

What are the SNRIs

Answer 36

Venlafaxine | Duloxetine

Question 37

DOC trigeminal neuralgia pain

Answer 37

Carbamazepine

Question 38

Anticonvulsant for postherpetic neuralgia and diabetic neuropathy

Answer 38

Gabapentin

Question 39

Anticonvulsant for postherpetic neuralgia and diabetic neuropathy and fibromyalgia

Answer 39

Pregablin

Question 40

Anticonvulsant for migraine prophylaxis

Answer 40

Valproate | Topiramate

Question 41

DOC glucocorticoid

Answer 41

Dexamethasone

Question 42

Misc Adjuvants

Answer 42

``` Hydroxyzine Clonidine Lidocaine Capsaicin Caffeine ```