Pain Management Flashcards
Analgesia
Absence of normal sense of pain
Anesthesia
Partial or complete loss of sensation, with or without loss of consciousness as a result of disease, injury or anesthetic
Hyperalgesia
Excessive sensitivity to pain- painful stimuli perceived as more painful- chronic pain
Hyperesthesia
Increased sensitivity to sensory stimuli such as pain or touch- chronic pain
Allodynia
Non painful stimuli percieved as painful- chronic pain
Dysthesia
Unplesant sensation in the absence of sensation- pins & needles- chronic pain
Hyperpathia
All stimuli- noxious and innocuous- are more intense- chronic pain
Provacative/ pallative
What makes pain better or worse
Quality
Character of pain
Region & referral
where it hurts and radiates
severity
Pain scale- plus quantity, characteristics, frequency & variability
timing
duration, frequency & consistency
Neuropathic pain
chronic pain- aberrant somatosensory process in PNS.
Pain disproportionate to lesion-maladaptive- tingling, sharp, shooting, electric, burning.
Ex: herpes, DM
Complex regional pain syndromes
Chronic pain following injury- damage or malfunction of PNS
Neuralgias
pain occurring along the course of the nerve- pressure, nutritional deficiency, toxin or inflammation
Phantom pain
perception of pain from body part that is no longer there
Radicular neuropathy
problem with specific spinal nerve- damage to nerve root
Nocioceptive pain
Ongoing activation of neural pain systems due to tissue damage or inflammation
Somatic nocioceptive
localized pain- activation of nocioceptors with out injury to nerve or CNS
Visceral nocioceptive
Deep, aching, squeezing pain
psychogenic pain
pain that is truly experienced but best explained by a psychiatric disease
Idiopathic pain
pain with no clear cause
Physical dependence
Body adapts to drug requiring more to achieve same effect- withdrawal effects
Tolerance
Body adapts to drug and requires more to achieve desired effect
Addiction
Compulsive drug use despite harmful consequences. Failure to meet obligations
Pain avoidance behavior
Adding negative emotion to pain signal- pain is much harder to control and may be triggered by memory of inciting incident- Avoid activities and increased disability
Nonpharmacologic pain management
CBT- relaxation & imagery
physical agents- massage, heat, cold
TENS units
Acetaminophen- Mech of action
Inhibits prostaglandin synthesis
Acetaminophen- Uses
Antipyretic & analgesic- not an anti platelet or anti-inflammatory
NSAIDS- ibuprofen & naproxen- Mech of action
Inhibit prostaglandin synthesis- COX pathway- modulation of pain, inflammation, platelet affregation and vasodilation
NSAIDs- Clinical uses
Pain modulation, inflammation & fever
Opioids- Mechanism of action
Interact with opioid receptors in CNS, cause hyper polarization of nerve cells
Opioids- Clinical uses
Analgesia to severe pain, Tx of diarrhea, cough relief, pulmonary edema
Opioids- Side effects
Euphoria, respiratory depression, depression of cough reflex, mitosis (pinpoint pupil), nausea
Bisphosphonates- Mech of action
Decrease osteoclastic bone resorbtion- decrease functionality of osteoclasts.
Bisphosphonate- Clinical uses
Bone pain, treatment of osteoperosis
Neuropathic Agents for pain relief- mech of action
Serotonin/ norepinephrine reuptake inhibitors-also used to treat depression
Ex amtyptiline
Anti-convulsants
Gabapentin- suppress nerve activity and firing- inhibit sodium gated channels
