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Nervous System: Unit II > Pain Management > Flashcards

Pain Management Flashcards

1
Q

Classification of pain

A
  • Duration: acute vs chronic
  • Origin: Nociceptive (somatic, throbbing, well localized) vs. Neuropathic (result of nerve damage, burning, tingling, shock like, or shooting)
  • Intensity: e.g. on a scale 1-10
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2
Q

General characteristics of nociceptive pain

A
  • Acute
  • Short duration and resolves
  • Directly related to tissue healing
  • Somatic
  • Associated with cancer
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3
Q

General characteristics of neuropathic pain

A
  • Chronic
  • Persists longer than would be expected
  • Related to a chronic disease
  • Without identifyable cause
  • Associated with cancer
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4
Q

Approach to management of acute pain

A
  • Early intervention and treatment
  • Prompt adjustments in therapy if inadequately controlled,
  • Reduction of pain to acceptible levels with minimization of side effects,
  • Facilitation of recovery from underlying injury/surgery/disease
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5
Q

Treatment goals of chronic pain

A
  • control pain and decrease suffering
  • functional restoration
  • decreased utilization of the health care system
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6
Q

Approach to chronic pain management

A
  • Enhancement of descending inhibitory pathways
    • Opiods
    • Antidepressants; block serotonin uptake
  • Decrease in central sensitization
  • Decrease in peripheral sensitization
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7
Q

Opioid analgesics: role in acute pain + efficacy

A
  • Role:
    • Moderate/severe pain
    • Decrease perception/rxn
    • Modulation
    • Transmission
  • Efficacy
    • Very - cornerstone of moderate to severe pain treatment
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8
Q

Local anesthetics: role in acute pain + efficacy

A
  • Role:
    • Transmission
    • Transduction
    • Intense, prolonged anesthesia
    • Opioid sparing
  • Efficacy
    • Very good
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9
Q

NSAIDs: role in acute pain + efficacy

A
  • Role:
    • mild pain tx
    • reduce perception/rxn
    • transduction
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10
Q

alpha-2 agonists: role in acute pain + efficacy

A
  • Role:
    • modulation of pain
    • reduce perception/rxn
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11
Q

NMDA-receptor antagonist: role in acute pain + efficacy

A
  • Role:
    • Modulation
    • Perception/rxn
    • Block ascending pathway
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12
Q

Opioid analgesics: Pharmacokinetics & SE

A
  • Pharmacok
    • Liver metabolized
  • SE
    • Respiratory depression, euphoria, constipation, nausea, vomiting, miosis, sedation, pruritis
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13
Q

Local anesthetics: Pharmacokinetics & SE

A
  • PharmacoK
    • Routes: neuraxial infusion or peripheral nerve block amongst others
  • SE
    • Neurotoxicity, hypotension, dizziness, drowsiness
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14
Q

NSAIDs: Pharmacokinetics & SE

A
  • PharmacoK
    • COX2 centrally
  • SE
    • hepatotoxicity
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15
Q

NMDA-receptor antagonist: Pharmacokinetics & SE

A
  • PharmacoK
    • IV
    • intranasal spray
  • SE
    • Anterograde amnesia
    • HTN
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16
Q

Standard tx for mild acute pain

A

non-opoid +/- adjuvant analgesics

17
Q

Standard tx for moderate acute pain

A

opioid for mild/moderate pain +/- non opioid +/- adjuvant analgesics

18
Q

Standard tx for severe acute pain

A

opioid for moderate/severe pain +/- non opioid +/- adjuvant analgesics

19
Q

Tricyclic antidepressants: role in chronic pain management, efficacy, pharmacoK, SE

A
  • role: descending pain inhibition
  • efficacy: good
  • pharmacoK:
  • SE: several toxic side effects
20
Q

Serotonin Norepinenphrine Reuptake Inhibitors (SNRIs): role in chronic pain management, efficacy, pharmacoK, SE

A
  • role: descending inhibition
  • efficacy:
  • pharmacoK:
  • SE:
21
Q

SSRIs: role in chronic pain management, efficacy, pharmacoK, SE

A
  • role: descending inhibition
  • efficacy:
  • pharmacoK:
  • side effects:
22
Q

Anticonvulsants: role in chronic pain management, efficacy, pharmacoK, SE

A

x

23
Q

Local anesthetics: role in chronic pain management, efficacy, pharmacoK, SE

A
  • role: peripheral sensitization
  • efficacy:
  • pharmacoK: local/targeted delivery possible
  • SE:
24
Q

Non-opioid analgesics: role in chronic pain management, efficacy, pharmacoK, SE

A
  • role:
  • efficacy:
  • pharmacoK:
  • SE:
25
Q

Opioid analgesics: role in chronic pain management, efficacy, pharmacoK, SE

A
  • role: descending inhibition
  • efficacy:
  • pharmacoK:
  • SE:

Nervous System: Unit II (19 decks)

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