Pain Definitions/Basics Flashcards
Acute Pain: other physiological sx
tachycardia, htn, diaphoresis (sweating), mydriasis
Chronic Pain: psych and nerves
social isolation, depression, anxiety
As pain signals are repetitively generated, neural pathways change and become hypersensitive
Malignant Pain
acute, chronic, or intermittent d/t cancer or chemo
Somatic Pain
skin, muscle, tendon, ligament, bone
sharp, stabbing, throbbing, aching
Visceral Pain
internal organs like liver, intestines, or stomach
Poorly localize, often referred pain far from problem
Neuropathic pain
Nerve damage - burning, numb, aching, electric shock
Neuro pain first line
TCAs, antiepileptics, serotonin-NE reuptake inhibitors
Nociception
Sensory nerve sends signal to spinal cord along ascending nerves. Secondary nerves in dorsal horn of spinal cord connects and relays to brain stem.
Descending Antinociception
ntms from descending fibers inhibit pain transmission
opioids resemble these ntms
Acute pain goal
Pain relief, short-acting meds
Malignant pain goal
Relieve patient’s pain without inducing disabling AEs
LA usually more appropriate, short acting for b/t
Chronic benign pain goal
Decrease intensity by at least 30%
Usually requires multimodal therapy-nerve blocks, rehab, PT, acupuncture, psychotherapy, meds
Non opioids and adjuvents involved
Adjuvent
primary indication is not pain (TCAs, antiepileptics, anesthetics,
Opioid MOA
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.
Mu receptor
Binding = analgesia, sedation, euphoria, respiratory depression, physical dependence, constipation, etc