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ASC182 > Topic 10: Pain Management > Flashcards

Topic 10: Pain Management Flashcards

1
Q

What is pain?

A

highly unpleasant physical sensation caused by illness or injury.

Pain occurs when tissues are injured or swollen, either due to trauma or surgery.

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2
Q

What is analgesia?

A

means by which we achieve relief from pain. Controlling pain is important as it reduces stress, improves the rate of healing and improves the overall quality of life.

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3
Q

What are signs to observe when looking for pain?

A
  • animal’s orientation in the cage
  • posture
  • level of movement
  • exercise tolerance and activity level
  • facial expression
  • attitude
  • vocalising
  • difficulty standing, walking, taking stairs, jumping, or getting up.
  • changes in urination and defecation habits
  • decreased grooming (especially in cats).
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4
Q

Common signs of pain in dogs?

A
  • Decreased social interaction
  • Anxious expression
  • Submissive behavior
  • Refusal to move
  • Whimpering
  • Howling
  • Growling
  • Guarding behavior
  • Aggression; biting
  • Decreased appetite
  • Self-mutilation (chewing)
  • Changes in posture
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5
Q

Common signs of pain in cats?

A
  • Reduced activity
  • Loss of appetite
  • Quiet/loss of curiosity
  • Changes in urinary/defecation habits
  • Hiding
  • Hissing or spitting
  • Lack of agility/jumping
  • Excessive licking/grooming
  • Stiff posture/gait
  • Guarding behavior
  • Stops grooming/matted fur
  • Tail flicking
  • Weight loss
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6
Q

What is acute pain?

A

pain that comes on immediately in the short term, and can often be quite severe.

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7
Q

What is chronic pain?

A

pain that develops over time, greater than a period of 10-14days, and can sometimes be mistaken for aging.

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8
Q

What is wind-up pain?

A
  • phenomenon where untreated pain becomes worse.
  • Nerve fibers transmitting the painful impulses to the brain become “trained” to deliver pain signals better.
  • Furthermore, the brain becomes more sensitive to the pain
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9
Q

PLATTER

what does this stand for in relation to pain management plants?

A
  • PLan
  • Anticipate -know we may cause pain, give analgesia prior
  • TreaT
  • Evaluate
  • Return
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10
Q

What non-pharmacological analgesia techniques can nurses perform?

A
  • hot/cold compression
  • managing weight
  • therapeutic excersise
  • acupuncture, laser, ultrasound
  • phys rehab
  • massage
  • nursing care
  • TLC
  • gentle handling
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11
Q

What are opiods?

A

act centrally to reduce the perception of pain

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12
Q

What are NSAIDS?

A

act locally at the site of pain to reduce inflammation.

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13
Q

How may pharmacological analbesia (opiods/NSAIDS) be given?

A
  • orally
  • parenterally (injection)
  • transdermal
  • local injection eg epidural
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14
Q

What is CRI?

A
  • Constant Rate Infusions
  • means of delivering analgesia drugs (usually opioids) constantly through an intra-venous drip
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15
Q

Describe opiod agonists

A
  • those that bind and stimulate opioid receptors in the CNS
  • VERY powerful and are most commonly used for ACUTE pain for a short period of time
  • eg morphine, methadone, pethadibe, fentanyl
  • associated with side effects
  • bradycardia
  • hypotension
  • sedation
  • resp. depression
  • urinary retention
  • vomiting
  • defecation
  • constipation
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16
Q

Describe opiod partial agonists

A
  • bind to receptors, but only partially stimulate
  • provide good analgesia with few side effects
  • have a ‘Ceiling effect’, which means that the degree of analgesia cannot be increased, even with increasing doses of the drug.
  • eg buprenorphine (temgesic)
17
Q

Describe opiod mixed agonists/antagonists

A
  • bind and stimulate some receptors, but bind, block and inhibit other receptors
  • side effects are reduced, although the level of pain relief is only moderate
  • work well for visceral pain
  • eg butorphanol (Torbugesic, Dolorex)
18
Q

Describe opiod antagonists

A
  • bind, block and inhibit opioid receptors
  • used for treating agonist opioid overdoses.
  • eg Naloxone.
19
Q

How do NSAIDS work?

A
  • act specifically at the site of pain or inflammation at the site of injury or disease NOT AT THE CNS
  • by interfering with prostaglandin production, which are chemicals made in response to inflammation.
  • BOTH pathways produce prostaglandins that promote inflammation, pain and fever, but ONLY COX-1, produces prostaglandins which protect the stomach lining and support platelet activity
  • Some NSAID’S inhibit BOTH COX 1 & COX 2, by blocking the COX 1 pathway we have the potential to damage stomach lining
20
Q

Contraindications for the use of NSAIDs (especially long term use) include?

A
  • renal insufficiency
  • dehydration
  • hypotension
  • low effective circulating volume e.g. congestive heart failure and shock
  • platelet and clotting factor problems,
  • gastrointestinal problems especially gastric ulceration
  • haemorrhage (e.g. trauma)
21
Q

Examples of NSAIDs include?

A
  • ketoprofen (Ketofen)
  • carprofen (Rimadyl)
  • salicylic acid (Asprin)
  • meloxicam (Metacam)
  • firocoxib (Previcox)
22
Q

A bit about Steroidal Anti-inflammatory Drugs (Corticosteroids)?

A
  • reduce inflammation by suppressing prostaglandin production, thereby providing analgesia
  • suppress the immune system and they also delay healing
  • should never be administered concurrently with NSAIDs
23
Q

Alpha-2 drugs do what?

A
  • suppress spinal cord pain transmission to the brain
  • fantastic sedative effects,
  • produce a pronounced hypotension and bradycardia
  • Due to these profound side effects they are used rarely and with caution.
  • eg xylazine, domitor
24
Q

What is general anaesthesia?

A

effects the entire body and results in a loss of consciousness i.e. commonly used for involved/invasive surgical procedures.

25
Q

What is local anaesthesia?

A

Focal anaesthetic provided to a particular area of the body ONLY e.g. superficial stitch-up.

26
Q

What is a nerve block?

A

An anaesthetic that is used to effect only a single nerve so that it cannot innervate a particular part of the body and the animal will subsequently feel pain no pain e.g. commonly used during dentals to extract teeth.

27
Q

What is a epdirual?

A

An anaesthetic agent that is introduced into the epidural space of the spinal cord so that pain cannot be felt e.g. Calving down cow

28
Q
A

ASC182 (17 decks)

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