Pain management

Question 1

pain pathway

Answer 1

transduction
transmission
perception of pain
modulation

Question 2

WILDA

Answer 2

Words
Intensity
Location
Duration
Aggravating and alleviating factors

Question 3

soft tissue involvement, musculoskeletal

ache, throbbing

Answer 3

somatic

Question 4

somatic pain is responsive to

Answer 4

NSAIDc/COX-2

opioids

Question 5

involves organs, referred pain

cramping, pressure, tightness

Answer 5

visceral

Question 6

visceral pain is responsive to

Answer 6

NSAIDs/Cox-2

opiods

Question 7

numbness, tingling, radiating, burning, shooting

Answer 7

neuropathic pain

nerve involvement

Question 8

neuropathic pain is responsive to

Answer 8

mildly to opioids
anticonvulsants
Antidepressants (TCA)

Question 9

short term
episodic
physiological changes

Answer 9

acute

Question 10

long term, baseline pain
breakthrough pain
no objective physiological signs

Answer 10

chronic

Question 11

the simultaneous use of different analgesic agents or forms of analgesic delivery that suppress pain transmission in the peripheral and CNS
can be designed to inhibit the release of noxious mediators, block conduciton in sensory nerves, suppress pain perception in the CNS

Answer 11

Multimodal Analgesia

Question 12

acetaminophen

NSAIDs/Cox-2

Answer 12

non-opioids

Question 13

unless contraindicated, any analgesic regimen should include ________ even if pain is severe enough to require the addition of an opioid

Answer 13

non opioid

Question 14

non-opioid of choice for patients with renal disease

Answer 14

Acetaminophen

tylenol

Question 15

extremely useful in pain that involves inflammation
adverse effect profile, GI, renal and CV
drowsiness and confusion common in elderly

Answer 15

non selective NSAIDs

Question 16

do not directly provide analgesia
used more extensively in chronic pain than acute pain
help with suffering

Answer 16

adjuvant medications

Question 17

antidepressants
anticonvulsants
benzodiazepines
muscle relaxants (short term use only)

Answer 17

selected adjuvant medications

Question 18

used for mild to mod pain
usually given in combination with non opioids which limits doses
rarely appropriate for post op pain or chronic pain
short-acting - used for rescue or pre-eptive
codeine, hydrocodone, oxycodone, tramadol

Answer 18

combination (weak) opioids

Question 19

used for moderate to severe pain
no maximum dose
can be given by many different routes
long-acting forms available for chronic pain

Answer 19

single-agent opioids

Question 20

paravertebral blocks for

Answer 20

thoracotomies
thoracoscopies
lung biopsy

Question 21

interscalene block

Answer 21

total shoulder arthroplasty

Question 22

provides continuous infusion of a local anesthetic at the surgical site
portable and requires little management by caregiver or patient

Answer 22

Peripheral nerve catheter PNC

Question 23

frequency of side effects such as nausea, vomiting, constipation, and sedation are reduced
places medication directly onto the cerebrospinal fluid

Answer 23

implantable (intrathecal) pumps

Question 24

delivers low voltage electric stimulation to the spinal cord to block the sensation of pain

Answer 24

neurostimulator

Question 25

empowers patients
takes focus away from medications
provides relaxation and relief from pain
diminishes emotional component of pain
decreases anxiety
decreases fatigue
improves quality of life

Answer 25

nonpharmacologic therapies