Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

xPharm Exam 1 > Pain & Pain Management > Flashcards

Pain & Pain Management Flashcards

1
Q

The loss of painful impression without the loss of tactile sense. For the alleviation of pain.

A

Analgesia

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

A behavioral pattern of dug use characterized by compulsive use, accompanied by psychological need.

A

Addiction

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

State of physiologic adaption to chronic use of a drug that abrupt dosage reduction results in abstinence syndrome.

A

Physical Dependence

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

State of physiologic adaptation to a drug such that higher than usual dosages are required to achieve the same effect.

A

Tolerance

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

Characteristic physical and emotional signs and symptoms precipitated by abrupt reduction or discontinuation of a drug on which an individual is physically dependent.

A

Withdrawal or abstinence syndrome

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

The dosage of analgesic beyond which no addition analgesia occurs.

A

Ceiling effect

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

Narcotics vs. Opioids

A
  • Narcotics are natural or synthetic with a morphine-like action
  • Opioids are derived from opium or synthetic drugs which have similar actions
  • Narcotics HAVE a ceiling effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

3 variables for the assessment of pain

A
  1. Behavioral: body movement/position, crying, facial expression
  2. Stress hormones: EPI, NE, insulin, glucagon, cortisol, aldosterone
  3. Physiological: heart rate, respiratory rate, oxygenation

-When pain is not effectively treated, stress and reflex reactions can caus hypoxia, hypercapnia, hypertension, cardiac activity, emotional difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

4 considerations in the management of pain

A
  1. Location, duration, intensity, characteristics of pain
  2. Coping strategies used by the patient
  3. Pain producing pathology of the underlying condition
  4. Previous pain relief interventions, including analgesics, and their success or failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic pain

4 things

A
  • Persists for more than 3 months
  • Usually resistant to standard pain therapy
  • 4 most common areas: lower back, headache, neck, facial
  • Consequences of pain included diminished physical function, psychological changes, social consequences, societal consequences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

2 types of chronic pain

A
  1. Identifiable/Malignant: ongoing, cause is known.

2. Nonidentifiable/Neuropathic: no known (or inadequate) cause of pain, has a neuropathic component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Neuropathic Chronic Pain

5 things

A
  • Symptoms wax and wane over time
  • Causes include diabetic peripheral neuropathy, alcohol, and more
  • Originates from an injury to PNS or CNS
  • Often mediated through NMDA receptor sensitization, substance P
  • Approaches to management include: antidepressants (TCAs, SNRIs), anticonvulsants, local anesthetic antiarrhythmics, sympatholytics, topicals and opioids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Antidepressants (for neuropathic pain)

6 things

A
  • First line treatment
  • TCAs are superior
  • Pain alleviation seems separate from antidepressant function
  • Used for: diabetic peripheral neuralgia, chronic back pain, fibromyalgia, post-herpetic nerve pain
  • TCAs: Amitriptyline, Imipramine, Clomipramine, Nortriptyline
  • SNRIs: Milnacipran HCL, Duloxetine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SNRIs (for neuropathic pain)

3 things

A
  • Milnacipran HCL
  • For fibromyalgia
  • ADRs: Headache, insomnia, dizziness, hot flashes, nausea, constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anticonvulsants (for neuropathic pain)

3 things

A
  • Pregabalin, Gabapentin (post herpetic neuralgia), Carbamazepine (most frequent)
  • Used for: headaches, neuralgias, TMJ pain
  • May be combined with antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pregabalin (for neuropathic pain)

4 things

A
  • Structurally similar to GABA
  • Used for: diabetic peripheral neuropathy, post herpetic neuralgia
  • ADRs: headache, dizziness, fatigue, weight gain, GI distress, peripheral edema
  • Do NOT stop abruptly, withdrawal may occur
17
Q

Local Anesthetic Antiarrhythmics (for neuropathic pain)

4 things

A
  • Lidocaine/Mexilitine
  • Decreases abnormal spontaneous and evoked discharge in damaged nerves
  • Does not affect other responses
  • Lidocaine response is predictive of mexilitine response
18
Q

Sympatholytics (for neuropathic pain)

4 things

A
  • Phentolamine/Clonidine
  • Turns off NE release
  • Phentolamine infusion predicts response to clonidine
  • Clonidine interacts with opioid receptors to suppress withdrawal symptoms, can also be used for spinal cord injuries and neuropathic pain
19
Q 
Topical Agents (for neuropathic pain)
5 things
A
  • Capsaicin (from chili peppers)
  • Counter irritant, may affect substance P
  • Used for allodynia (light mechanical stimulation of skin caused pains)
  • Adlea: TRPV1 agonist (C-neuron anesthetic)
  • Other topicals can include a clonidine patch
20
Q

Chronic Malignant Pain

A
  • Treat pain assoicated with terminal illness aggressively
  • Regular, scheduled doses of pain relievers are better than as needed
  • 70-90% receive complete relief
  • Approaches to management include: Non-opioids (NSAIDs, Acetaminophen, Duloxetine) and opioids
21
Q

NSAIDs (for chronic malignant pain)

4 things

A
  • Block COX mediated transformation of arachidonic acid to prostaglandins
  • Ibuprofen: bone pain
  • Ketrolac: short term (under 5 days), ACUTE pain that requires analgesia at opioid level
  • Caution in elderly and decreased renal function
22
Q

Opioids (for chronic malignant pain)

5 things

A
  • Oral is best if possible
  • Always dose around the clock
  • Alter schedules for renal and hepatic dysfunction
  • DOC for elderly and very young
  • ADRs: constipation, nausea, vomiting, sedation, respiratory depression, miosis
23
Q

Bone pain

A
  1. NSAIDs (ibuprofen)
  2. Steroids
  3. Bisphosphonates
24
Q

Management of pain in old people

5 things

A
  • Treat aggressively
  • Use a pain scale to measure
  • NSAIDs should be used with caution (renal probs)
  • Acetaminophen is DOC for mild/moderate musculoskeletal pain
  • Opioids are good for moderate to severe pain
25
Q

Endogenous Opioid Peptides

4 things

A
  • Formerly endorphins
  • Interact with opioid receptors
  • Includes: enkephalins, dynorphins and beta-endorphins
  • May moderate pain through positive/negative feedback
26
Q

Duloxetine (for chronic pain management)

A

-Reduces joint pain associated with breast cancer treatment

xPharm Exam 1 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions