Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2229 > WEEK 6 Pain Management > Flashcards

WEEK 6 Pain Management Flashcards

1
Q

Identify 5 principles for optimal pain management

A
  1. Balanced analgesia
  2. Dosage and timing
  3. Consider patient co morbidities
  4. Utilise administration modalities
  5. Tailor treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the concept of balanced analgesia (Principle for optimal pain management)

A

Class of medication should be determined by the pathology of the pain and the effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the concept of dosage and timing (Principle for optimal pain management)

A

Pre emptive (Don’t wait until they tell you they are in pain)
Regular analgesia
Break through analgesics
Treat side effects promptly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the concept of considering co morbidities (Principle for optimal pain management)

A

Age, opioid tolerance, substance abuse, respiratory compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the concept of tailoring treatment (Principle for optimal pain management)

A

Patient involvement, regular assessments of adequacy of analgesia, reassessment of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe acute pain in terms of pain management

A

Limited trajectory (Healing process), individually tailored approach, predominantly nociceptive pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe persistent pain in terms of pain management

A

Often multifactorial, neuropathic and nociceptive, requires multimodal approach, individualised approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Identify 3 populations why may require particular attention within pain management

A

Children
Pregnant patients
ATSI/CALD groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Outline the components of the biopsychosocial model in terms of pain management

A

BIO: Assess for changes/injury in physical body
PSYCHO: Address anxiety/stress
SOCIAL: Consider social situation/home environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Outline the 3 components of a pain management plan

A
  1. Assessment (History, Physical exam, further investigations)
  2. Management (Pain management options, information, assurance and advice encouraging normal activity)
  3. Review (Reassess and revise plan)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Identify the 3 WHO strategies

A
  1. WHO: Pharmacological Treatment Strategy
  2. WHO: Guidelines for pain management
  3. WHO: Analgesic Ladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the WHO: Pharmacological Treatment Strategy

A

Underlying cause of pain should be treated where possible , Individualised therapy, use a systematic approach (Ladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

WHO: Guidelines for pain management

A

Non pharmacological approach first, non opioid medicines first, co analgesics and adjuvant medicines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the WHO: Analgesic Ladder

A

Idea is that you start from the bottom and build up as required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe step 1 of the WHO: Analgesic Ladder

A

Non opioids (With or without adjuvants), Non pharmacological approaches and or Paracetamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe step 2 of the WHO: Analgesic Ladder

A

Weak opioid (With non-opioid) (With or without adjuvants) NSAID and/or oral opioid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe step 3 of the WHO: Analgesic Ladder

A

Strong opioid and non-opioid (With or without adjuvants) with increased dose of oral opioid or an IV/IN Fentanyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Discuss how choice of medication should be made

A

Based on underlying pain mechanisms
Acute pain: Regulated by opioidergic system
Persistent pain: Associated with neuropathic componenet were central sensitisation requires a reduced role of opioids/increased contribution of adjuvant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Identify the recommended medications for nociceptive pain

A

NSAIDS and Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Identify the reccomended medications for neuropathic pain

A

1st line: Antidepressants, anticonvulsants and topical agents
2nd line: Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe simple analgesics for pain management

A

Paracetamol for soft tissue/musculoskeletal origin and NSAIDS for muscular skeletal inflammation and tissue injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Identify the 3 types of NSAIDS with example for each

A

NON selective: Ibuprofen
COX-2 Specific: Celecoxib
Long Acting: Meloxicam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe opioids for pain management and an example

A

For moderate to severe pain, 3 primary receptors (Mu, Delta and Kappa), morphine and oxycodone

24
Q

Describe Tramadol for pain management

A

Opioid receptor agonist, Enhances noradrenergic and serotonergic inhibition, less constipating

25
Q

Describe Ketamine for pain management

A

NDMA Antagonist, for acute and persistent pain, post op pain effective

26
Q

Describe Cannabis for pain management

A

Bind with endocannabinoid receptors and suppress signals such as pain, nausea, depression and boost appetite, euphoria

27
Q

Describe anticonvulsants for pain management and an example

A

Used for neuropathic pain, fibromyalgia, modulates neurotransmitter release e.g. Pregablin

28
Q

Describe Antidepressants for pain management

A

Can exert analgesic action without any effects on mood in patients with persistent pain

29
Q

Describe Tapentadol for pain management

A

Mu opioid receptor agonist/Noradrenaline reuptake inhibition (MORNRI), used for nociceptive and neuropathic pain, contribute to analgesic activity

30
Q

Describe Adjuvant agents for pain management

A

Meds that are not typically used for pain but may be helpful for its management. They have a primary indication other than pain. Used to make analegsics more effective e.g. Diazepam

31
Q

Describe Local anaesthetic agents for pain management

A

Relieves pain by acting directly on damaged pain fibres under the patch, e.g. Lignocaine

32
Q

Describe Capsacin for pain management

A

Depletion of substance P = decreased transmission of pain signals, period of weeks brings in full effect

33
Q

Describe topical agents for pain management

A

Applied directly to the skin

34
Q

Describe the rationale for multimodal analgesia

A

Target multiple mechanisms of pain conditions, used to lower risk of treatment related side effects

35
Q

Describe the use of a multimodal approach for persistent pain management

A

Aim is to help patients improve functionality and to promote patient responsibility for managing disease

36
Q

What may be required to achieve optimal pain management

A
  • Peripheral stimulation and interventional activity e.g. accupuncture
  • Active physiotherapy and movement therapy
  • Psychological therapy (relaxation, CBT)
  • Education of patient and relatives
37
Q

Identify 3 aspects of non pharmacological measures for pain management

A

Environment: Controlling stimulus e.g. loud noise
Physical comfort: Distraction, heat pack
Emotional elements: Empathy

38
Q

What are complementary and alternative therapies used for?

A

Therapeutic modalities used to augment orthodox approaches e.g. western medicine

39
Q

Define alternative therapies

A

Therapies used outside of traditional medicine

40
Q

Define Complementary Alternative Medicine (CAM)

A

Diagnosis, treatment and/or prevention that complements mainstream medicine by contributing to a common whole

41
Q

Identify 3 principles of CAM

A

Human mind body can promote healing
Illness affects the whole person
Therapies should be supportive not cause harm

42
Q

Identify the 4 classifcations of CAM

A
  1. Whole medical systems e.g. Traditonal chinese medicine
  2. Mind body medicine e.g. meditation
  3. Biologically based practice e,g, herbs, vitamins
  4. Manipulative and body based practices e.g. Chiropractor, massage
43
Q

Describe Accupuncture (CAM)

A

Ancient chinese medical procedure involving insertion and manipulation of needles, believed to stimulate endirphins, serotonin and noradrenaline in CNS

44
Q

Describe Cognitive Therapies (CAM)

A

Aim is to alter a persons belief system and modify undesirable behaviour patterns/perceptions

45
Q

Describe CBT (CAM)

A

Cognitive Behavioural Therapy, helps to reframe thoughts and change patterns of thinking, usually aimed at reducing stress or threat value of pain and enhancing ability to cope with pain

46
Q

Define coping in CBT (CAM)

A

Acceptance of pain rather than pain control or relief

47
Q

Identify 3 requirements of CBT

A

Identify steps towards achieving goals, consistently reinforce efforts towards goal achievement, actively involve patient in process of modifying thoughts

48
Q

Describe Hypnosis (CAM)

A

Creates a trancelike state that resembles normal sleep during which perception and memory are altered, resulting in increased responsiveness to suggestion e.g. burns dressings

49
Q

Describe Nutrition (CAM)

A

Protein required, reduce sugar and starchy carbs, may need to review certain foods, vitamin D and opioids and constipation = Increase fluids and fibre

50
Q

Describe Herbal/other medicines (CAM)

A

Capsacin (neuropathic pain), fish oils for OA

51
Q

Describe Massage therapy (CAM)

A

Relaxation of voluntary muscles, sedation of nerve sensors and improved circulation to area, endorphins are also released = feeling of relaxation

52
Q

Describe Meditation (CAM)

A

If you can calm and focus your mind, you may be able to control your pain and degree of feeling

53
Q

Describe Music therapy (CAM)

A

Used to divert attention away from pain to promote relaxation and wellbeing = Reduced pain intensity and opioid requirements

54
Q

Describe Spinal and Joint Manipulation (CAM)

A

Massage, stretching and joint manipulation used by chiropractors etc.

55
Q

What does TENS stand for?

A

Transcutaenous Electrical Nerve Stimulation

56
Q

Describe TENS machine (CAM)

A

Electrical stimuli on the skin preferentially activate low threshold myelinated nerve fibres inhibiting nociception by blocking transmission along fibres to dorsal horn

57
Q

Describe Yoga (CAM)

A

Uses physical postures to obtain harmony of the mind body and spirit, shifts balance from sympathetic NS to parasympathetic NS, improve oxygenation to body tissues, clear and relaxed mind

2229 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions