Pain Management Flashcards

1
Q

What are two types of pain?

A
  • Nociceptive

- Neuropathic

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

What is nociceptive pain?

A
  • Noxious stimulus (chemical, thermal, mechanical) of nociceptors releases neural chemicals that also stimulate other nociceptors
  • Transmits signal to spinal cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sharp localized pain =

A

Large diameter, sparsely myelinated

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

Dull, aching pain =

A

Small diameter, unmyelinated

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

Perception of pain =

A

Conscious experience of pain

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

Pain impulse is relayed through ___

A

Thalamus

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

___ transmit pain

A

Higher cortical structures

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

Modulation =

A
  • Inhibition of impulses via the brain stem (body’s natural response to pain so you can go and get help)
  • Release of endogenous opioids, serotonin, NE, GABA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is neuropathic pain?

A
  • Sustained by abnormal processing of sensory input
  • Nerve damage, persistent stimulation, autonomic dysfunction
  • Burning, tingling, shocks, hyperalgesia, allodynia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic pain

A

> 3 months OR past the time of normal tissue healing

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

PQRST for monitoring pain

A
P: palliative and provocative factors
Q: quality
R: radiation
S: severity
T: temporal relations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Addiction

A

Using the medication beyond what it’s intended for; negatively impacting their daily lives

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

Abuse

A

Use of the medication beyond its intended use

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

Tolerance

A

Not getting the same therapeutic effects at current dose

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

Dependence

A

Require the medication for regular activities of daily living/normal quality of life

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

Who is at risk for inadequate pain control?

A
  • Racial and ethnic minority groups
  • Women
  • Elderly
  • Persons with cognitive impairment
  • Cancer and at the end of life
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the optimal length of opioid prescriptions for general surgery procedures?

A

4 to 9 days

18
Q

What is the optimal length of opioid prescriptions for women’s health procedures?

A

4 to 13 days

19
Q

What is the optimal length of opioid prescriptions for musculoskeletal procedures?

A

6 to 15 days

20
Q

What pain meds work on transduction?

A
  • NSAIDs
  • COX-2 inhibitors
  • Antihistamines
  • Topical local anesthetics
21
Q

What pain meds work on conduction?

A
  • Peripheral nerve block

- Local anesthetics

22
Q

What pain meds work on transmission?

A
  • Epidural block

- Local anesthetics

23
Q

What pain meds work on modulation?

A
  • Opioids
  • Clonidine
  • COX-2 inhibitors
24
Q

What pain meds work on perception?

A
  • Opioids
  • Acetaminophen
  • Clonidine
  • TCAs
  • Gabapentin
25
Q

What pain meds work on CNS responses?

A
  • Muscle relaxants
  • TCAs
  • Beta blockers
26
Q

Opioid receptors are located throughout…

A

The brain, spinal cord, and GI tract

27
Q

Four subtypes of opioid receptors

A
  • Delta
  • Kappa
  • Mu
  • Nociceptive
28
Q

Delta

A
  • Brain and peripheral nerves

- Analgesia, antidepressant, dependence

29
Q

Kappa

A
  • Brain, spinal cord, periphery

- Analgesia, sedation, miosis, dysphoria, ADH inhibition

30
Q

Mu

A

-Brain, spinal cord, periphery, intestine

31
Q

What are 3 types of mu receptors?

A
  • Mu1
  • Mu2
  • Mu3
32
Q

Mu1

A

Analgesia, dependence

33
Q

Mu2

A

Respiratory depression, euphoria, reduced GI motility, dependence

34
Q

Mu3

A

Unknown

35
Q

Nociceptive

A
  • Brain, spinal cord

- Anxiety, depression, appetite, tolerance to mu agonists

36
Q

NMDA receptor may reduce ___. Why?

A

Opioid effectiveness, d/t overstimulation by glutamate (neuropathic pain)

37
Q

How to combat NMDA receptor/opioid effectiveness

A

Augment via GABA receptors and NMDA receptor antagonists

38
Q

Agonist

A

binds to the receptor and causes its effect

39
Q

Partial agonist

A

Not a full signal, weaker than an agonist

40
Q

Agonist-antagonist

A

made as an attempt to reduce side effects of opioids

41
Q

Antagonist

A

Reversal of opioids