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239B > Pain Control > Flashcards

Pain Control Flashcards

1
Q

Musculoskeletal Pain

A

NSAIDS

COX-2

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2
Q

Example NSAID

A

Ibuprofen

naproxen

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3
Q

Example of COX-2

A

diclofenac

celecoxib( celebrex)

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4
Q

Neuropathic Pain

A 
Anticonvulsants 1st line
and Analgesics
THEN
TCA
anticonvulsants 2nd line
SSRI
Anti-arrhythmic agent
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5
Q

Example anti-convulsants 1st line- neuropathic

A

Gabapentin (neurontin)

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6
Q

Example Analgesics anti-convulsants-neuropathic

A

PREGABLIN

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7
Q

Example TCA-neuropathic

A

amitriptyline (Elavil)
nortirptyline (Pamelor)
imipramine (Tofranil)
desipramine (Norpramin)

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8
Q

Example Anti-convulsants 2nd line - neuropathic

A

Phenytoin (Dilantin)
Carbamazepine (Tegretol)
Valporic Acid (depakote)

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9
Q

Example SSRI- neuropathic

A

Fluoxetine (Prozac)
Sertaline (Zoloft)
Paroxetine (Paxil)
Duloxetine (CYmbalta)

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10
Q

Example Anti-arrhythmic - neuropathic

A

Lidocaine

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11
Q

Nociceptive Pain

A

Opioids

Pure Opioids

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12
Q

Example Opioids - nociceptive

A

tramadol, percoet, codeine, tylenol 3, vicodin

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13
Q

Example of Pure Opioids- nocicpetive

A

Morphine, oxycodone, hydromorphone, fentanyl, methadone

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14
Q

Tolerance

A

medication is less effective over a prolonged period use of drug

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15
Q

Dependence

A

medication has become physiologic requirement: abstinence syndrome develops if drug withdrawn

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16
Q

Addiction

A

behavioral reaction from drug misuse; drug seeking; it is characterized by following behaviors: impaired control over drug use, compulsive use, continued use despite harm and craving

17
Q

Pseudoaddiction

A

behavioral reaction d/t inadq or under tx of pain

18
Q

Somatic

A

Well localized, aching, throbbing, gnawing, activation of nociceptors in cutaneous and deep tissue
bone mets, soft tissue injury - OA, post op

19
Q

Visceral Pain

A

poorly localized
deep aching, cramping, pressure, referred
activation of nocicpetors resulting from strech distention or inflammation
BO, billiary colic

20
Q

Neuropathic Pain

A

Spinal cord, brain, PNS

shooting, shock like, burning, n/t/itch

21
Q

Nociceptive 4 parts pathway of pain

A

Transduction- receptors trigger with injury
Transmisison- into spinal cord (a delta-c fibers)
Perception
Modulation- turn “down” signal natural endorphins, epi

22
Q

Indications for XRAY

A 
trauma
neurologic deficit
systemic symptoms
temp >38
wt loss
hx CA, steriod use, ETOH use
23
Q

XRAY show

A

DDD, osteophytes (bridity of bone), instability, alignment, axial instability, basilar InVagination, compression fx

24
Q

“Dynamic “ xrays

A

-ordered to evaluate the overall structural integrity
- extreme ROM
-measurement of curvature
*no info about deformation of discs, facets, ligaments, or soft tissue
movement with neck hyperextension/flexion

25
Q

MRI show

A 
confirm what you already know!
soft tissue
nerves
discs
osseus structures
ligaments
bone, disc, ligaments, neural elements, facet joints, paraspinal musculature
26
Q

high false + MRI

A

asymptomatic patients in lumbar spine and cervical

27
Q

CT show

A
  • contraindication ot MRI- pacer, sharpnel in orbit, aneurysmal clips
  • bony detail- neuro compression
  • visualize neurological structure improve with myelogram
28
Q

CT for

A

bone sx, quick to sit through, fx, bld, osseus structure, osteophytes, foramenal stenosis, spinal stensosi, deg changes

29
Q

Bone Scan

A

screening tool, tumor, infection, occult fx

ID mets, infection, occult fx

30
Q

TENS

A

nerve stimulation w/ mild electrical current, interrupt pain transmission, variety of uses adn modes, electrodes placed on site of pain NOT for prego or implanted devices

31
Q

Heat

A

muscle tension, spasma, arthritis, NOT for lbd, topcial patches, irritated skin

32
Q

Cold

A

muscle spasm, HA, trauma, surgical, incisional pain, NOT for poor circulation or irritated skin

33
Q

Basic Comfort Measures

A

positioning, environ, pacing rest, support devices

34
Q

Physical Exercise

A

45 mins- ROM , passive exercises, best for general MS pain, OA, exercise tolerance if CV risk

35
Q

WHO 3 step analgesic for

A

non-opioid and adjuvant- Tyl, NSAID
Opioid with adjuvant- codeine, hydrocodone, oxycodone, dihydrocodiene
opioid + adjuvant- morphine, methadone, fentanyl, oxycodone, hydromorphone

239B (14 decks)

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