Review

Question 1

Acute Nociceptive Pain

Answer 1

Mild- non opioids
Moderate
Severe- opioid, +/- multimodal analgesia, non opioids

Question 2

Non opioid treatments for mild pain

Answer 2

NSAIDs (1/2)
Aspirin (1/2)
Acetaminophen (CNS 2)
Celecoxib (2)

Question 3

Classification of Pain by Severity-Intensity

Answer 3

Behavior
Cognitive
Social
Cultural

Question 4

Multimodal Analgesia

Answer 4

Local anesthesia
Ketamine
Clonidine

Severe pain

Question 5

Local anesthesia target

Answer 5

Voltage sensitive Na channels

Question 6

Ketamine target

Answer 6

NMDA receptor block

first synapse

Question 7

Clonidine target

Answer 7

a2

Question 8

Clonidine

Answer 8

Treats high blood pressure. A lower blood pressure can reduce the risk of strokes and heart attacks. Also treats attention deficit hyperactivity disorder (ADHD). Belongs to a class of drugs called antihypertensives.

Question 9

Chronic Neuropathic Pain

Answer 9

mild- mod: non opioid

–Adjuvants: block central sensitization (NMDA). perf sens (PG), and ↑ descending inhibition (u)

Severe: Tramadol
Buprenorphine
Opioid

Question 10

Central Sensitization

Answer 10

NMDA mediated

Question 11

Peripheral Sensitization

Answer 11

PG

Question 12

Tramadol

Answer 12

↑ u, ↓ NE

Question 13

Buprenorphine

Answer 13

Treats moderate to severe chronic pain. This medicine is a narcotic analgesic.

Partial u

Question 14

Acute pain is primarily ____________ - somatic more common than visceral

Answer 14

nociceptive

Question 15

Classification of Pain by Duration

Chronic Pain

Answer 15

persisting beyond the normal healing time (neuropathic)

no identifiable organic cause (e.g., fibromyalgia, irritable bowel syndrome)

Pain related to a chronic disease (e.g., osteoarthritis)

Pain, chronic and acute, associated with cancer

Question 16

Severe pain, Crying out scale

Answer 16

7-8

Question 17

Stressed, tense, expression, Least pain

Answer 17

1-2

Question 18

Moaning, restless, Moderate pain

Answer 18

5-6

Question 19

Classification of Pain by Origin

Nociceptive Pain

Answer 19

“Normal” pain resulting from activation of nociceptive nerve fibers

Somatic pain - arising from skin, bone, joint, connective tissue, or muscle due to:

Musculoskeletal conditions, Inflammation, Mechanical/compressive problems

Described as throbbing and well-localized

Visceral pain (arising from internal organs) can manifest as arising from other structures (referred) or be well-localized

Question 20

Neuropathic Pain

Answer 20

Distinct from nociceptive pain - persists and has become disengaged from noxious stimuli or the healing process

Result of nerve damage. Syndromes include: diabetic neuropathy, postherpetic neuralgia

Abnormal operation of the nervous system. Syndromes include: fibromyalgia, irritable bowel syndrome, tension type headache

Described as burning, tingling, shock-like or shooting

Question 21

Opioids in chronic pain?

Answer 21

YES for Cancer!

Question 22

Inhibitors of monoamine reuptake (TCADs-SNRIs) are NOT effective for

Answer 22

ACUTE pain

Question 23

result of nerve damage

Answer 23

Neuropathic

Question 24

Receptor Targets at Projection Neuron

Answer 24

u-k opioid
α2-adrenergic
NMDA-Glu

[5HT3 (chronic pain)]
[5HT1D (migraine)]

Question 25

Receptor Targets at Projection Neuron (PN)

Answer 25

α2-adrenergic
u-k opioid
NMDA-Glu

[5HT3 (chronic pain)]
[5HT1D (migraine)]

Question 26

____________ are NOT effective for ACUTE pain

Answer 26

Inhibitors of monoamine reuptake (TCADs-SNRIs)