Pain Management in Palliative Care - FM Flashcards
What is the definition of pain in palliative care?
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
Why is understanding “total pain” essential in palliative care?
Pain management must address physical, psychological, social, and spiritual aspects for optimal relief.
What are the four domains of total pain?
Physical, psychological, social, and spiritual pain.
What is physical pain, and how does it typically present?
Pain caused by stimulation or damage to sensory nerve endings; presents as dull, aching, or stabbing.
What are common causes of psychological pain in palliative patients?
Anxiety, guilt, sadness, anger, fear, bereavement, and emotional disturbances from the past.
How does social pain manifest in palliative care?
Loss of role (e.g., breadwinner), financial worries, stigma, and social alienation.
What is spiritual pain, and what are its common causes?
Existential distress, meaninglessness, loss of faith, and hopelessness.
What factors influence the perception of pain?
Attention, anxiety, past experiences, suggestion, psychological state, and sensory nerve patterns.
What does the PQRST framework stand for in pain assessment?
Provocative, Quality, Radiation, Severity, Temporal.
What are the common pain assessment tools?
Numerical Rating Scale (0-10), Jerrycan Scale, Hand Scale.
What is the difference between nociceptive and neuropathic pain?
Nociceptive pain is due to normal pain pathways; neuropathic pain results from nerve damage.
What are the two types of nociceptive pain?
Somatic pain and visceral pain.
How does somatic pain differ from visceral pain?
Somatic pain is well-localized, while visceral pain is deep, dull, and poorly localized.
What are common causes of neuropathic pain?
Cancer infiltration, nerve compression, HIV infection, herpes zoster, and drug toxicity.
Why might neuropathic pain be resistant to opioids?
It may not respond well to opioids and often requires adjuvant therapy.
How is oral morphine dosed and administered in palliative care?
Given every 4 hours; titrated individually; has no ceiling dose.
What is the WHO Analgesic Ladder?
A stepwise approach to pain relief, progressing from non-opioids to strong opioids.
Why should weak opioids never be given with strong opioids?
They act on the same receptors and may not provide additional benefit.
What are some examples of adjuvant drugs used in pain management?
Antidepressants (Amitriptyline), anticonvulsants (Gabapentin), corticosteroids, benzodiazepines (Diazepam).
Why should a laxative be prescribed alongside opioid therapy?
Opioids cause constipation, so a laxative prevents complications.
What are the benefits of oral morphine in palliative care?
Provides smooth pain control, metabolized to M6G for sustained effect.
How is pain reassessed in palliative patients?
Pain should be reassessed regularly, especially with changes in the patient’s condition.
What is the “Jerrycan Scale” and where is it commonly used?
A culturally adapted pain scale used in some African countries.
Why is a multidimensional approach necessary for effective pain management?
Pain has multiple dimensions beyond just physical sensations.
