Pharm Approaches To Pain Flashcards
What are analgesics?
Drugs that relieve pain without causing loss of consciousness
What is hyperalgesia?
Increased response to a stimulus that is normally painful
What is hypoalgesia?
Diminished response to a painful stimulus
What is hyperesthesia?
Increased sensitivity to a stimulation excluding the special senses
What is hypoesthesia?
Diminished sensitivity to stimulation excluding the special senses
What is dysesthesia?
An unpleasant abnormal sensation whether spontaneous or evoked
What is paresthesia?
An abnormal sensation whether spontaneous or provoked
What is allodynia?
Pain resulting from a stimulus (such as light touch) that does not normally elicit pain
What is nociceptive pain?
Perception of input from a nociceptor, a nerve fiber preferentially sensitive to noxious stimuli
What is somatic nociceptive pain?
Arises from injury to body tissues; well localized but variable in description and experience
What is visceral nociceptive pain?
Arises from viscera stretch receptors; poorly localized, deep, dull and cramping
What is neuropathic pain?
Arises from abnormal neural activity secondary to disease, injury, or dysfunction of the NS, commonly persists without ongoing disease
What is used to treat mild pain?
Non opioid analgesics (NSAIDs, acetaminophen)
What is used to treat moderate pain?
Non opioid analgesics + opioids
What is used to treat severe pain?
Non opioid analgesics + opioids + adjuncts
What are some non-pharm treatment options for pain?
Exercise, physical therapy, other physical modalities (heat, ice, massage), sleep hygiene, behavioral/psychological therapies, healthy lifestyle, acupuncture
What is the action of PGI2?
Vasodilation and decrease platelet aggregation
What is the action of TxA2?
Vasoconstriction and increased platelet aggregation
What are the similarities between COX1 and 2?
Both use same substrates, make the same products, have a role in inflammation, have a physiological role in renal function
What are unique characteristics of COX1?
Expressed in all tissues all the time (constitutive), prominent role in responding to physiological stimuli, also contributes to response to any pathological stimuli that release AA from cells (ex inflammation)
What are unique characteristics for COX2?
Expression induced in some tissues sometimes, physiological role in kidney (complements COX1), prominent role in response to any pathological stimuli that release AA from cells (ex. Inflammation)
What are the recommendations for reducing cardiovascular risk?
All NSAIDs should be used at their lowest effective dose, and should be avoided where possible in pts with CVS risk factors, used only when sufficient pain relief is not achieved with other options, and where NSAID therapy is required for pts at risk of complications, naproxen is recommended as the NSAID of choice
What are the contraindications for NSAID use?
CKD with creatinine clearance less than 60, active ulcer, cardiovascular disease particularly heart failure or uncontrollable HTN, NSAID allergy, ongoing treatment with anticoagulants (warfarin)
What does acetaminophen not cause?
Suppresses pain and fever but not inflammation; does not cause GI ulceration, suppress platelet aggregation or impair renal function
