Pain Flashcards
Inferior Infarct presents how?
Vagally
sweaty, clammy
Abdo, nausea, vomiting, deep central
Why do you get referred pain in MI?
Visceral from anterior infarct going into T1-4 sympathetics there is cross over to the somatic nerves from T1-4 so you get left arms pain.
Right sided pain if posterior infarct
What is the biggest risk factor for chronic pain?
Second highest?
Third?
Severity of pain at time of trauma
Worker’s comp
Education level
What predicts acute zoster?
Past history Age TCAs Severity of the pain Treatment Time to presentation
What goes down as you get older?
Headaches
Abdo pain
Replaced by MSK and neuropathic
Why older ppl present later with pain probs?
Ability to downregulate and upregulate pain is impaired
NSAIDS work how?
Peripherally: prostaglandins - cox1&2
Centrally: Spinal cord
Opioids work how?
Mu
Kappa
Delta
Increases PAS/PVS
Morphine dosage normally?
0.1 mg/kg
Orally 30mg
0.1mg intrathecally
Heroin is what?
Opioids: twice as potent as morphine
Resp depression
N/V
Itch
Constipation
Bupremorphine works how? Two ways
Partial agonist: won’t have tolerance
Blocker in addiction
Why give O2 post op on opioids?
Because sedation, decreased Resp rate, increase CO2. Give O2 so can offset it.
Ketamine is?
NMDA blocker
TCAs/SNRIs affect how?
NMDA
Gabapentin for?
Calcium channel blocker
