Pain Nguyen Flashcards
What is acute pain?
< 4 weeks to 3 months
usually happens quickly (eg injury)
List objective physical signs and symptoms that may indicate a patient is in acute pain (5)
increased BP and HR diaphoresis pallor Inflamation Behavioral changes in patients that can't communicate
What are the types of chronic pain?
neuropathic pain, cancer pain
If babies are in pain, how might they present?
irritable, fussy, change in feeding habits
If demented adults are in pain, how might they present?
agitation, calling out
Is aspirin recommended for pain treatment?
no
What is the major side effect of aspirin?
Increased bleeding risk due to irreversible action on platelets
What is the major side effect of APAP? What is the max dose?
hepatotoxic
3 grams
Why may APAP be preferred over NSAIDs in patients with risk of GI bleeding
APAP - no risk of GI bleeding while NSAIDs have that side effect
Drug interactions: What other drugs, if used with NSAIDs, may cause additive bleeding?
other NSAIDS, aspirin
Drug interactions: Will 2 NSAIDs increase efficacy?
Yes
Which NSAID is COX2 selective?
Celecoxib
What are the 4 major side effects of NSAIDs?
Risk heart attack and stroke, increase GI events, increased bleeding with other drugs that increase bleeding, nephrotoxicity
What are the therapeutic effects of opioids?
Pain reduction - mod-severe
What are the 5 major side effects associated with opioids?
Respiratory depression
CNS side effects
Constipation
Nausea and vomitting
Which of the 5 major side effects is the dose limiting side effect of opioids?
resp depression
What is the most concerning side effect of opioids that can be fatal? To monitor for this side effect, what vital sign do you monitor?
Resp depression; Respiratory rate
What are the CNS side effects of opioids?
Parasympathetic nervous system
Besides CNS, what other side effect of opioids can contribute to falls?
Hypotension
Which opioid is associated with the most histamine release?
Morphine
What is a strategy to manage opioid-related constipation?
methylnaltrexone
Lubiprostone
Naloxegol
Tolerance to all opioid side effects will occur except for which side effect?
Constipation
What dosage forms are available for naloxone that may be furnished by pharmacists over the counter?
Nasal spray, injectable
