Pain and Pharmacology Flashcards
what are the 6 classifications of pain
Acute, Chronic, Relapsing, Somatic, visceral, neuropathic
what is somatic pain?
sharp, localised fast pain usually results from outside (delta fibres)
what is visceral pain?
dull and not localised, slower pain that comes from internal (c-fibres)
how to assess pain (acronym)
Onset Location Duration Character Aggravating factors Relieving factors Timing Severity
Indications of Entonox (3)
combination use
labour
to gain IV access
Contraindications of Entonox (6)
Diving in 24 hrs head injury reduced GCS psychotic episode eye surgery bowel obstruction
cautions of enotnox (3)
abdo pain
alcohol
drugs
how does entonox work?
causes release of internal opioids and sends impose down defending pain pathway. Agonist at GABA receptors
indications for paracetamol (3)
mild to moderate pain
combine with other analgesia
antipyretic
paracodynxmics of paracetamol
inhibits prostaglandins synthesis by inhibiting COX pathways. acts on descending pain pathway
indications of Morphine (2)
cardiac pain
moderate to serve pain
contraindications of Morphine (5)
respiratory depression hypotension LOC head injury children under 1
cautions of morphine (5)
pregnancy chest injuries intoxication renal impairment small head injury
pharmacodynamics of morphine
CNS agonist
Pharmcodynamics of Diazepam
CNS depressant, stimulates GABA (an inhibitory neurotransmitter)
Indications for Diazepam? (3)
Convulsions lasting longer than 5 mins Repeated convulsions (3 or more in 1 hr) symptomatic cocaine toxicity
contraindications for Diazepam (1)
known sensitivity
Cautions for Diazepam (2)
alcohol
if dose has been given by carers
mechanism of action for midazolam
GABA stimulant which depresses the CNS
indications for midazolam (1)
First intervention for long or repeated convulsions
indications for glucagon (1)
hypoglycaemia
cautions for glucagon (2)
starvation
seizures
contraindications for glucagon (2)
adrenal tumor
IV
Pharcodynamics of glucagon
raises blood sugar by activation of hepatic glucagon receptors, stimulation glycogenolysis and release of glucose
indications for glucose IV (3)
hypoglycaemia (less then 4)
unconscious pt
did not respond to IM glucagon
cautions for glucose IV (1)
flush well after administration to avoid vein irritation
pharmcodymanics of glucose
direct delivery go glucose to the body so the body does not need to produce it. enters the normal cycle and converted into energy (glycolysis)
indications for ondansetron (2)
opiate induced nausea
nausea or vomiting
cautions for ondansetron (4)
Long QT
hepatic impairment
pregnancy
breast feeding
contraindications for ondansetron (2)
children under 1 month
known sensitivity
pharmacodynamics of ondansetron
selective serotonin 5HT receptor antagonist.
