Pharm Ch 10 basics

Question 1

actue pain

Answer 1

sudden, last less than 6 weeks

Question 2

agonist

Answer 2

a substance that binds to a receptor and causes a response

Question 3

nociceptors

Answer 3

sensory nerve fibers that result in pain

Question 4

most important receptors in pain

Answer 4

mu - in dorsal horn of spinal cord, then kappa and delta

Question 5

less mu receptors =

Answer 5

more pain, and vice versa

Question 6

pain threshold is…

Answer 6

physiological

Question 7

pain tolerence is…

Answer 7

psychological

Question 8

visceral and superficial pain usually requires..

Answer 8

opioids

Question 9

somatic pain usually requires (bone pain)

Answer 9

NSAIDS

Question 10

vascular pain (you know this so well)

Answer 10

headaches

Question 11

central pain

Answer 11

tumors, trauma, inflammation, disease (cancer, diabetes, stroke, MS)

Question 12

nociception

Answer 12

gate permits action potentials from spine to cerebral cortex and you feel pain

Question 13

gate theory

Answer 13

tissue injured - substances like bradykinin, histamine, potassium, prostaglandins and seratonin released.
then action potential at distal end of sensory nerve fibers. they go to dorsal horn where gates are located.

Question 14

gate is activated by

Answer 14

large A fibers and small C fibers

Question 15

A fibers…

Answer 15

close the gate

Question 16

C fibers…

Answer 16

open the gate

Question 17

A and C allow

Answer 17

the brain to evaluate, indentify and localize the pain. Then it closes or opens the gate.

Question 18

sharp and localized pain - A or C?

Answer 18

A

Question 19

dull and non-localized - A or C?

Answer 19

C

Question 20

the body’s painkillers

Answer 20

enkephalins and endorphins

Question 21

1 in 3 americans

Answer 21

ongoing pain

Question 22

PCA

Answer 22

morphine pump

Question 23

PCA by proxy

Answer 23

killed family w/ morphine pump

Question 24

tolerence can occur in little as a

Answer 24

week

Question 25

drugs added to opioid regime

Answer 25

NSAIDs, antidepressants, antiepileptic and corticosteroids (this is synergy)

Question 26

allodynia

Answer 26

bed sheets hurt w/ neuropathy

Question 27

3-step analgesic ladder

Answer 27

step 1 - nonopioids
step 2 - opioids
step 3 - opioids w/ or or without nonopioids or adjuvant meds

Question 28

opioids are classified as

Answer 28

both mild agonists and strong agonists

Question 29

strong trend away from (route)

Answer 29

intramuscular injections

Question 30

opioids can be classified by their…

Answer 30

chemical structure or their mechanism of action

Question 31

chemical structure is…

Answer 31

morphine-like, meperidine-like, and methadone-like

Question 32

opioid mechanism of action

Answer 32

angonist, agonist-antoagnist, or antogonist

Question 33

equianalgesia

Answer 33

hydromorphone (dilaudid) 7 times more potent than morphine

Question 34

opioid tolerant

Answer 34

a week or longer - 60 mg morphine daily, oral oxy 30 mg daily, minimum of 8 mg oral hydromorphone daily, or any other opioid equivalent.

Question 35

immediate release opioids usually last about

Answer 35

4 hours

Question 36

contraindications to opioids

Answer 36

known allergies and severe asthma

Question 37

codeine comes from

Answer 37

opium - natural opiate

Question 38

codeine is only agonist with

Answer 38

ceiling effect (increasing dose will not increase response)