Pain Review Questions

Question 1

How do you get the most information about a patients pain?

Answer 1

From what the patient tells you

Question 2

What types of medications are given as adjuvants?

Answer 2

corticosteroids, antidepressants, antiseizure drugs, GABA receptor agonists, alpha adrenergic agonists, local anesthetics

Question 3

Adjuvants: Corticosteroids

Answer 3

(Prednisone, Dexamethasone) Inflammation. best for cancer pain, spinal cord compression, inflammatory joint pain, many side effects, don’t give with NSAIDS

Question 4

Adjuvants: Antidepressts

Answer 4

(Elavil, Cymbalta) Neuropathic pain. Increases serotonin and norepinephrine, promotes sleep, don’t give if hx of seizures or cardiac disease, bad for older adults (long half life), many side effects,

Question 5

Adjuvants: Antiseizure Drugs

Answer 5

(Lamictal, Neurotonin, Lyrica) Neuropathic pain, Multimodal therapy for acute pain, Fibromyalagia. Affect peripheral nerves and CNS

Question 6

Adjuvants: GABA receptor agonists

Answer 6

(Baclofen) Nueropathic pain, Muscle spasms. Inhibits pain transmission, used for muscle spasms, best used intrathecally

Question 7

Adjuvants: Alpha Adrenergic Agonists

Answer 7

(Clonidine, Zanaflex) Used for chronic headaches, neuropathic pain

Question 8

Adjuvants: Local Anesthetics

Answer 8

(Lidocaine, Zostrix) Interrupts transmission of pain signals to the brain, works for types of neuropathic pain

Question 9

What is the goal for chronic pain?

Answer 9

Control pain to the extent possible, focus on enhancing function and quality of life

Question 10

What do you do if a patient on a PCA is waking up every night with pain?

Answer 10

Consider switching to a different medication in the PCA

Question 11

What pain meds should rarely ever be used, especially for chronic pain?

Answer 11

Darvon, Darvocet

Question 12

When do you do choose to give a rapid acting IV opioid?

Answer 12

Breakthrough pain

Question 13

What is the best medication to give an elderly patient with complaints of mild pain? Why?

Answer 13

Tylenol, less effect on GI

Question 14

When should you withhold pain medicine in a terminal ill patient with severe pain?

Answer 14

Never

Question 15

What concerns should you have about OTC pain meds?

Answer 15

GI problems, bleeding, analgesic ceiling, drug interactions, side effects

Question 16

What is breakthrough pain and how do you manage it?

Answer 16

Transient, mild to severe pain that occurs in pts whose baseline persistent pain is otherwise mild to moderate and fairly well controlled. Peak 3-5 minutes, can last 30 minutes

Question 17

What is breakthrough pain and how do you manage it?

Answer 17

Transient, mild to severe pain that occurs in pts whose baseline persistent pain is otherwise mild to moderate and fairly well controlled. Peak 3-5 minutes, can last 30 minutes. Several transmucosal fentanyl products are specifically used to treat BTP