Pain Medications Flashcards
What are some non-pharmacologic methods for pain management?
- massage
- heat or cold
- meditation
- acupuncture
- relaxation therapy
What are the 3 opioid receptors?
- Mu
- Kappa
- Delta
Where are the opioid receptors found?
Brain, spinal cord and GI tract
What are Mu and Kappa receptors associated with?
Analgesia and pain management
What feeling is associated with Mu receptors?
Euphoria
What receptors are associated with physical dependence?
Mu and delta
What is acute pain?
- abrupt onset w brief duration
- source and cause of pain is usually easy to define
What is chronic pain?
- lasts longer than 6 months
- often difficult to identify the cause
- can lead to feelings of helplessness and hopelessness
- interferes w ADL’s
What are 2 classes of pain?
- Nociceptive
2. Neuropathic
What is nociceptive pain?
Result of an injury to a tissue which usually responds well to pharmacotherapy.
What are 2 types of nociceptive pain?
- somatic
2. visceral
What is somatic pain?
Sharp/localized pain in the muscles or joints
What is visceral pain?
Dull, throbbing, or aching pain in the organs.
What is neuropathic pain?
Result of an injury to a nerve, less responsive to pharmacotherapy. Feels like burning, shooting or numbing pain.
What does the P stand for in PQRST?
Provoking factors: events that cause or aggravate pain
What does the Q stand for in PQRST?
Quality and quantity; description of pain and rating of intensity
What does the R stand for in PQRST?
Region and radiation: origin of pain and whether it spreads from that origin
What is referred pain?
Pain that is experienced somewhere distant from the actual source of the pain
What does the S stand for in PQRST?
Signs and symptoms: measurable, observable indications of pain including inflammation and subjective factors expressed by the patient (nausea, dizziness)
What does the T stand for in PQRST?
Timing: onset, duration, and recurrence
What two classes of drugs can be used for pain management?
- Opioids
2. Non-Opioids
What are opioids?
They bind mu and kappa receptors to produce analgesia, indicated for moderate to severe pain.
Name 3 natural opioids?
- morphine
- codeine
- oxycodone
Name a synthetic opioid:
Fentanyl
What’s an opioid antagonist?
Naloxone (narcan) - blocks mu and kappa receptors
What is methadone?
A mu receptor agonist but does not cause euphoria; used to treat addiction
Name 2 non-opioids:
- NSAIDS
2. acetaminophen
What are 3 examples of NSAID’s?
- ASA
- celebrex
- ibuprofen
Name two examples of opioid + non-opioid combination:
- Percocet (oxycodone + acetaminophen)
2. Percodan (oxycodone + ASA)
When should opioids be used?
Moderate to severe pain
What are some side effects of opioids?
- sedation, euphoria, relaxation
- constipation, nausea, vomiting
- urinary retention
- orthostatic hypotension, dizziness
- respiratory depression
- dependence, pruritis
What are some of the trade names of morphine?
- Kadian
- M-Eslon
- MS Contin
- MS-IR
- Statex
What are the uses of morphine?
- acute and sever chronic pain
- relieving acute MI
How does morphine work?
It occupies mu and kappa receptors in the brain and dorsal horn of the spinal cord
If the resps are lower than ___ then morphine should be withheld?
<12
What do opioids do to GI motility?
Reduce motility and promote constipation
What does Naloxone do?
It reverses respiratory depression when acute opioid intoxication has occurred by blocking mu and kappa opioid receptors.
The use of opioid antagonists such as naloxone may cause:
Withdrawal symptoms
What are the side effects of Naloxone?
- tend to be the opposite to effects of opioids
- loss of analgesia
- increased bp
- hyperventilation
- tremors
- nausea, vomiting
- drowsiness
How long do withdrawal symptoms last for in a patient who is physically dependent on opioids?
7 days
Do psychological or physical withdrawal symptoms last longer?
Psychological, cravings can persist for years after discontinuing the drug
What is “methadone maintenance”?
When people who are dependent on opioids take methadone orally to prevent withdrawal symptoms but you don’t get the euphoric effects of the drug.
How do NSAIDs work?
They reduce the production of prostaglandins at the site of injury by blocking cyclooxygenase (COX) therefore reducing inflammation and pain.
What are some of the adverse effects of NSAIDs?
- GI effects (ulceration of mucosa)
- dizziness, headache, and rash
- anti-clotting properties
How does acetaminophen work
Equal efficacy to ASA, blocks COX in central nervous system
Name another NSAID?
Aspirin
What is aspirin used for?
- mild to moderate pain
- inflammation
- fever
- clot reduction
- risk reduction of stroke and MI
What are some of the adverse effects of aspirin?
- gastric discomfort and bleeding
- increased clotting time
