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Pharmacology for Advanced Practice Nurses > Pain > Flashcards

Pain Flashcards

1
Q

McCaffery defined pain as

A

as
“whatever the experiencing patient
says it is and exists whenever he
says it does.”

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2
Q

The International Association for the
Study of Pain (IASP) has defined
pain as

A

The International Association for the
Study of Pain (IASP) has defined
pain as

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3
Q

Three things we think about when we think about pain

A

Duration
Acute or Chronic
Source of Pain

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4
Q

Classifications of pain

A 
Cancer related,
nociceptive,
neuropathic,
visceral, somatic,
headache, the
generalized pain
of fibromyalgia,
etc
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5
Q

Pain involves the interactions of three

major systems:

A

Sensory/discriminative system
• Motivational/affective system
• Cognitive/evaluative system

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6
Q

Pain threshold

A

The point at which that stimulus is experienced as
pain
• Differs from person to person

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7
Q

Pain tolerance

A

The duration of time or the intensity of pain that a
person will endure before taking overt action to
relieve the pain
• Decreases with repeated exposure to pain
• Decreased by fatigue, anger, fear, and sleep
deprivation

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8
Q

Neurological basis of Pain

A

Anatomy
• Afferent pathways
• Efferent pathways
• Physiology
• Tissue injury results in the production of arachidonic acid.
• Cyclooxygenase (COX) is needed to produce
prostaglandins.
• Prostaglandins lead to stimulation of nociceptors.
• Neuropeptides are associated with local pain and
inflammation.
• Norepinephrine and serotonin modulate pain in the
medulla and the pons.

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9
Q

Efferent pathways are responsible for

A

modulating the sensation of pain

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10
Q

Enodorphins are

A

inhibit neuropeptides and acts as body’s natural pain killer

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11
Q

Endorphine facts - 5 facts

A

Attach to the opiate receptors in the spinal
cord and brain
• Inhibit the release of neuropeptides
• Opioid agonists: are exogenous opiates
• Opiate receptors in the hypothalamus
• Certain activities increase circulating
endorphins

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12
Q

opioid recptors

A

Mu
Kappa
Delta

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13
Q

Mu

A

Analgesic
• Euphoria
• Respiratory depression
• Physical dependence

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14
Q

Kappa

A

Analgesic

Sedation

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15
Q

Delta

A

Less analgesic
• Emotional and affective components of the pain experience
• Physical dependence

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16
Q

Delta have important

A

Emotional and affective components of the pain experience

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17
Q

Sigma

A

Technically no longer considered opioid receptors. Have psychomemitic effects. Produce dysphroa. PCP works on this

18
Q

Acute pain

A

less than 6 months duration

19
Q

Acute somatic

A

arises from connective tissue, muscle, bone, and skin

20
Q

Acute visceral

A

pain in the interanal organs and abdomen

21
Q

Referred pain

A

pain that is present in an area distant from its point of origin

22
Q

Acute somatic pain responds well to

A

acetaminophin, opoids, corticostroids, nsaid, local anthethics, ice and massage

23
Q

Acute visceral pain responds well to

A

opoids

24
Q

Chronic Pain

A

3 to 6 months OR beyond expected period of healing

25
Q

Chronic Pain is centrally located and can be

A

Non-neuropathic pain
• Neuropathic pain
• Psychogenic pain

26
Q

pure opioid agonists exampels

A

morphone and codeine

27
Q

mixed opioid agonist example Mu

A

buprenorphine

28
Q

mixed opioid agonists example kappa

A

pentazocine

butorphanol

29
Q

pure opioid antagonist

A

naloxone

30
Q

Purue opoid agonists work on

A

mu and kappa

31
Q

Mu effects

A 
analgeisa 
decreased GI motility
respiratory depression
sedation
dependence
32
Q

kappa effects

A

analgesia
decreased GI motility
sedation

33
Q

opoid agonists work

A

centrally to relieve pain

34
Q

opoid agonists bind to

A

opioid receptors, produce multiple responses

throughout the body.

35
Q

Moderate to serve pain what is 1st line

A

opoid

36
Q

Opoids can supress and slow what

A

Suppress cough, slow motility of the GI tract

37
Q

Adverse effect with opoids

A

Adverse effect: n/v, constipation, sedation and respiratory

depression*

38
Q

Schedule II opoid examples

A

Schedule II opioids - fentanyl, hydromorphone,

methadone, morphine, oxycodone, and oxymorphone.

39
Q

Opioid Antagonists

A

• Blockers of opioid activity
• Reversal agents
• Naloxone (Narcan)
• Over-sedation and respiratory depression/arrest
• Opioid antagonists can be provided in combo with
opioids for patients with respiratory ailments

40
Q

Opioids with Mixed Agonist-Antagonist Activity*

A

Stimulate opioid receptor; withdrawal symptoms or
adverse effects are not as intense due to partial activity of
receptor subtypes

41
Q

Opioids can be combined with

A

non-narcotic analgesics (synergistically)

42
Q

Examples of opioid mixed agonists-antagonist activity

A

Buprenorphine

Pharmacology for Advanced Practice Nurses (50 decks)

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