Palliative care Flashcards
What are the 4 aspects of total pain?
Physical; social; psychological; spiritual
Define nociception
Unconscious afferent response to traumatic or noxious stimuli
Define pain
Conscious, subjective, uniquely personal experience
Describe C fibres
Unmyelinated, transmit dull, poorly localised, ill-defined sensation
Describe A delta fibres
Myelinated, transmit sharp, fast, well localised sensation
What is the ‘gate control theory of pain’?
Describes the plasticity of the A delta fibre’s synapse with 2nd order neurones in the dorsal horn.
Describe somatic pain. What is it often treated with?
Well localised, often responds well to NSAIDs
Describe visceral pain. What are the treatment options?
Poorly localised, often responds well to NSAIDs and steroids
Define Allodynia
Central pain sensitisation following painful, often repetitive stimulation
What are the treatment options for someone suffering neuropathic pain?
Opioids, NSAIDs, anti-depressants, anti-convulsants, steroids
What are the 2 analgesia options for incident pain (pain associated with movement - a type of breakthrough pain)?
Transmucosal opioids, oral liquid morphine
What is the dose of morphine given for breakthrough pain?
1/6th of the total daily (24 hour) morphine requirements
What should be prescribed alongside morphine permanently?
A laxative
What are the signs of opioid toxicity?
Myoclonic jerks, depressed respiration, renal failure (due to metabolites of morphine accumulating)
Where is the vomiting centre?
In the reticular formation of the medulla inside the BBB
