Pain Flashcards
Drug Class Used to Reverse the Effects of Opioids
Opioid Antagonists
Drug Classes for Treating Pain
Opioid Analgesics
Non-Opioid Analgesics
Anti-migraine Agents
Opioid Receptors
Mu Kappa Sigma Delta Epsilon
Opioid (narcotic) Analgesics
Used to relieve moderate to severe pain
Some used for anaesthesia
Morphine
An opioid analgesic and agonist
Interacts with mu and kappa receptors
Primarily used as an alagesiac and anaesthesia
Adverse effects include respiratory depression, sedation, nausea, and vomiting and dysphoria(restlessness, depression, anxiety)
Monitoring Opioid Therapy
Assess potential for opioid dependancy
Have narcotic antagonists available to reverse negative effects
Assist clients with activity as they may be quite disoriented.
Monitor urine output for retention
Monitor bowel habits for constipation
An initial assessment should screen for severe respiratory disorders, increased inter cranial pressure, seizures, and liver/renal disease
Treatment for Opioid Dependance
Physical dependancy lasts 7 days
Psychological dependance can last many months or years
Often clients switch from IV and inhaled forms to oral form called Methadone
Methadone does not cure addiction but avoids withdrawal symptoms and does not have the euphoric effect
Opioid Antagonists
Used to reverse effects of opioids
Used for overdoses or in cases of overly aggressive pain therapy
Naloxone (Narcan) and Naltrexone (ReVia)
Naloxone (Narcan)
Opioid Antagonist
Used to reverse opioid effects
Mechanism of action is the blocking of mu and kappa receptors
Minimal toxicity, however adverse effects or reversing analgesia of increases BP, tremors, hyperventilation, nausea/vomiting, and drowsiness
Employed when
Acute vs Chronic
Acute is intense pain occurring over a defined time, usually less than 6 months
Chronic pain lasts longer than 6 months and interferes with daily activities. Chronic pain is associated with feelings of hopelessness
Nociceptor vs Neuropathic
Nociceptor is a pain whose source is due to tissue injury. It can be somatic (sharp and localized) or visceral (dull, throbbing, aching)
Neuropathic pain is due to injury of the nerves and is a burning, shooting or numbing pain.
Nociceptor pain responds well to conventional pain-relief drugs while neuropathic pain often has less therapeutic success
Opioids
Act on CNS
Exert action by interacting with receptors, the most important of which are mu and kappa.
Agonists stimulate the receptors while antagonists block it.
Drugs of choice for moderate to severe pain
Mu receptor
Opioid receptor
Analgesia, decreases GI motility, respiration depression, sedation and physical dependance
Kappa receptor
Opioid receptor
Analgesia, decreased GI motility, sedation
NSAID
Nonsteroidal Anti-Inflammatory Drug
Act by inhibiting pain mediators at nociceptor level
Inhibit cyclooxygenase(COX) an enzyme responsible for formation of prostaglandins.
Inhibition of COX results in reduced pain and inflammation
