Pain Definitions/Basics Flashcards

1
Q

Acute Pain: other physiological sx

A

tachycardia, htn, diaphoresis (sweating), mydriasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chronic Pain: psych and nerves

A

social isolation, depression, anxiety

As pain signals are repetitively generated, neural pathways change and become hypersensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Malignant Pain

A

acute, chronic, or intermittent d/t cancer or chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Somatic Pain

A

skin, muscle, tendon, ligament, bone

sharp, stabbing, throbbing, aching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Visceral Pain

A

internal organs like liver, intestines, or stomach

Poorly localize, often referred pain far from problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Neuropathic pain

A

Nerve damage - burning, numb, aching, electric shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Neuro pain first line

A

TCAs, antiepileptics, serotonin-NE reuptake inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nociception

A

Sensory nerve sends signal to spinal cord along ascending nerves. Secondary nerves in dorsal horn of spinal cord connects and relays to brain stem.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Descending Antinociception

A

ntms from descending fibers inhibit pain transmission

opioids resemble these ntms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute pain goal

A

Pain relief, short-acting meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Malignant pain goal

A

Relieve patient’s pain without inducing disabling AEs

LA usually more appropriate, short acting for b/t

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chronic benign pain goal

A

Decrease intensity by at least 30%
Usually requires multimodal therapy-nerve blocks, rehab, PT, acupuncture, psychotherapy, meds
Non opioids and adjuvents involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adjuvent

A

primary indication is not pain (TCAs, antiepileptics, anesthetics,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Opioid MOA

A

Mimic endogenous opioid peptides in antinociceptive pathway - binding opioid receptors as AGONIST for analgesia. Opioid receptors are in CNS, pituitary, GI tract,
gray matter of brain, and dorsal horn of spinal cord.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mu receptor

A

Binding = analgesia, sedation, euphoria, respiratory depression, physical dependence, constipation, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Delta receptor

A

Analgesia without many AEs (but no delta agonists exist)

17
Q

Kappa receptor

A

Analgesia, respiratory depression

Also anxiety, strange thoughts, nightmares, hallucinations

18
Q

Pure opioid agonist

A

Morphine (Methadone has NMDA too)

Primary activate mu, some kappa, most clinicaly useful

19
Q

Mixed agonist-antagonist

A

Agonist at kappa - weak analgesia
Weak antagonist at mu - dysphoria, pshychomimetic effects
Pentazocine is prototype
Buprenorphine is partial agonist at mu and kappa

20
Q

Opioid antagonists

A

block mu and kappa recptors, reverse respiratory and CNS effects
Naloxone, naltrexone

21
Q

Tolerance

A

larger dose same response
sometimes mistaken for dz progression in ca pt
NO TOLERANCE: constipation and neuroendocrine effects

22
Q

Physical dependence

A

withdrawal syndrome if stopped/quickly decreased

23
Q

Addiction

A

use for nonmedical reasons, despite harm, decreased control/compulsive use, craving