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Summer Pharm - Exam 2 > Pain Overview > Flashcards

Pain Overview Flashcards

1
Q

acute pain scale 1-3 =

A

mild

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2
Q

acute pain scale 4-6 =

A

moderate → moaning/restless

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3
Q

acute pain scale 7-10 =

A

severe → crying out

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4
Q

tx for acute mild pain (1-3)

A

NSAIDs

APAP

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5
Q

tx for acute moderate pain

A

opioids w. slow titration

NSAIDs

+/- adjuvant

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6
Q

tx for acute severe pain

A

short acting opioids w. rapid titration

NSAIDs

+/- adjuvants

multimodal

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7
Q

pain = __

+ __

A

perception + reaction

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8
Q

acute pain is primarily __

A

nociceptive

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9
Q

5 common causes of acute pain

A

surgery

acute illness

trauma

labor pain

medical procedures

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10
Q

2 types of acute/nociceptive pain

A

somatic

visceral

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11
Q

throbbing, well localized pain

A

somatic

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12
Q

referred pain

A

visceral

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13
Q

3 benefits of multimodal analgesia/synergism

A

lower doses

opioid sparing

limits s.e

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14
Q

3 non opioid analgesic classes

A

NSAIDs

COX-2 selective

APAP

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15
Q

non-opioid analgesics are commonly used for (4)

A

analgesia

inflammation

antipyretic

antiplatelet

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16
Q

which non opioid analgesic does NOT help w. inflammation

A

APAP

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17
Q

what non opioid analgesic is commonly used for antipyretic and antiplatelet effects

A

ASA

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18
Q

4 indications for opioids

A

“nope” →

neuropathy → acute and chronic ca

oa → unresponsive to non opioids

post herpetic/dm neuropathy → unresponsive to non opioids

episodic exacerbations of severe pain

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19
Q

3 synthetic opioids

A

fetanyl

methadone

heroin

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20
Q

2 natural opioids

A

hydrocodone

oxycodone

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21
Q

deaths from opioids low to high

A

“methadone helps heal fentanyl”

methadone

heroin

hydro/oxycodone

fetanyl

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22
Q

how do local anesthetics produce analgesia

A

block all sensory pain afferent neurons

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23
Q

LA are commonly used for

A

minor surgical procedures

commonly used w. epi

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24
Q

6 classes of adjuvant therapy

A

“adolescent alice learned abc”

anticonvulsants

antidepressants

local anesthetics

antispasmodics

benzos

corticosteroids

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25
Q

which 3 adjuvant analgesics are used for neuropathic pain

A

anticonvulsants

antidepressants

local anesthetics

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26
Q

which adjuvant analgesic is used for anxiety

A

benzos

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27
Q

3 types of chronic pain by duration

A

neruopathic

functional

nociceptive

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28
Q

chronic pain that persists beyond the normal healing time for an acute injury

A

neuropathic

29
Q

pain w.o identifiable organic cause

abnormal operation of nervous system

A

functional

30
Q

chronic pain related to chronic dz

ex ca or OA

A

nociceptive

31
Q

2 ex of functional pain

A

fibromyalgia

IBS

32
Q

exaggerated response to normal pain stimuli

A

hyperalgesia

33
Q

painful response to normal nonnoxioius stimuli

34
Q

3 targets of pain sensation/drug therapy

A

brain → descending inhibition

peripheral

central

35
Q

2 brain receptors associated w. descending inhibition

A

NE/serotonin

opioid receptors

36
Q

pathways associagted w. peripheral pain inhibition (2)

A

VSSC

prostaglandins

37
Q

pathways associated w. central pain inhibition (3)

A

VSCC

NMDA receptors

prostaglandins

38
Q

what 4 drugs target descending inhibition

A

SNRIs

TCADs

tramadol

opioids

39
Q

what 2 drugs inhibit peripheral sensitization to pain

A

lidocaine → VSSC

NSAIDs → PG

40
Q

what 4 drugs inhibit central sensitization

A

gabapentin/pregabalin → VSCC

ketamine → NMDA

NSAIDs/APAP → PG

41
Q

what substance enhances both peripheral and central pain inhibition

42
Q

what 2 drugs activate opioid receptors in the descending inhibitory pathway

A

opioid analgesics

tramadol

43
Q

what 2 drugs block NE-5HT reuptake in the descending inhibitory pathway

A

antidepressants ->

TCAD

SNRI

NOT SSRIs

44
Q

what drug blocks VSCC → decreases NT release

A

anticonvulsants

45
Q

what drug blocks NMDA-Glu receptors

46
Q

what 3 drugs block COX2

A

NSAIDs

celecoxib

APAP

47
Q

what drug blocks VSSC

48
Q

what comorbidity is commonly associated w. chronic pain

49
Q

what 2 classes of drugs are emphasized in chronic pain

A

non opioid analgesics

adjuvants

50
Q

best drugs for mild to moderate somatic pain

A

non opioid analgesics

51
Q

4 common indications for non opioid analgesics

A

lbp → soft tissue injury

strains/sprains

HA

OA/RA

52
Q

pharm if pain is localized to specific joints

A

topical NSAIDs

53
Q

3 benefits of adjuvant analgesics

A

enhance analgesic efficacy

treat concurrent sx exacerbating pain

provide independent analgesic activity

54
Q

2 ex of TCAD/secondary amine

A

nortriptyline

desipramine

55
Q

4 indications for TCADs as adjuvant

A

DM neuropathy

postherpetic neuralgia

lbp

migraine

56
Q

4 ex of SNRIs

A

duloxetine

venlafaxine

milnaciprain (savella)

57
Q

indication for SNRI as adjuvant analgesic

A

fibromyalgia

58
Q

3 ex of SSRIs

A

proxetine

fluoxetine

sertraline

59
Q

t/f: SSRIs are less effective as adjuvant analgesic than TCADs and SNRIs

60
Q

what does a2o ligand make you think of

A

anticonvulsants

61
Q

2 ex of anticonvulsants

A

pregablin

gabapentin

62
Q

4 indications for anticonvulsants as adjuvant analgesics

A

trigeminal neuralgia

DM neuropathy

postherpetic neuropathy

spinal cord injury

63
Q

pharm if pain is localized to specific anatomic area

64
Q

___ are less effective for chronic pain and have no long term benefit

65
Q

t/f: recovery from chronic pain is 4x less likely in pt taking opioids

66
Q

opioids should be reserved for __ pain

that adversely affects __

A

mod-severe

ADLs/QOL

67
Q

opioids are controlled substances classified as

68
Q

mainstays of tx for neuropathic pain syndromes

A

antidepressants

anticonvulsants/antiepileptics

Summer Pharm - Exam 2 (12 decks)

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