Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
58 Cards in this Set
- Front
- Back
|
What are the 5 goals of pain management?
|
1) Eliminate/ suppress pain
2) Manage/support inciting cause of pain 3) Improve patient comfort -non-pharmacological? 4) Eliminate/ suppress pain behavior -promote normal behavior 5) Remove stress or distress -good nursing care -sedative & anxiolytics |
|
|
What are 3 aspects of pain that should be assessed?
|
1) Cause
-inflammatory, neuropathic etc 2) Severity -mild, moderate, severe, excruciating 3) Duration -acute, chronic -ongoing "wind-up" or pre-emptive |
|
|
What are 7 considerations of pain management with regards to the patient & owner?
|
1) signalment
2) History -medicla, pharm, pain, env't 3) Route of administration -drug choice, compliance 4) Drug efficacy 5) Drug safety -toxicity, interactions 6) Clinical experience 7) owner expectations 8) Therapeutic failure? |
|
|
What are 5 major therapeutic methods used for pain management?
|
1) Opioids
2) alpha-2 agonists 3) NMDA receptor antagonists 4) Local anesthetics 5) NSAIDs 6) Non-drug therapies |
|
|
What are 6 examples of non-drug therapy used for pain management?
|
1) Physiotherapy
2) Acupuncture 3) Massage 4) Heat & cold 5) Laser 6) Electromagnetic tx |
|
|
What are 2 general methods of anti-pain drug therapy?
|
1) Block perception of painful stimuli= anesthetics
2) Increase animal's tolerance to pain= analgesics |
|
|
What are the 4 treatments that can used for multimodal therapy/
|
1) NSAIDs
2) Opioids 3) Effective anesthesia 4) Innovative approaches -transdermal, intrathecally, oral, transmucosal |
|
|
Reduction of stress, _____, _____ will improve pain management.
|
Fear, anxiety
|
|
|
What are 3 agents that can be used to reduce reactions of animals in pain?
|
1) Tranquilizers/ sedatives
-acepromazine 2) Anxiolytics -midazolam -diazepam -zolazepam 3) Neuromuscular blockers |
|
|
Describe the analgesic properties of local and general anesthetics.
|
Locals: excellent pain blockade
General: poor analgesia |
|
|
What primarily causes pain within the first 12 hours of injury? What should be used to treat?
|
Inflammatory pain
-use NSAIDs |
|
|
What are 3 concerns of using NSAIDs in felines?
|
1) Variable metabolism
2) Predictability w/ multiple doses 3) Renal failure |
|
|
What COX system is correlated to GI safety?
|
COX-2
-Renal safety, idiosyncratic liver toxicity & efficacy are not |
|
|
What is the best indicator of NSAID safety?
|
Post-licensing adverse-event data reported to FDA
|
|
|
What is the most common use of NSAIDs in chronic therapy?
|
Chronic osteoarthritis
-first line of treatment -very effective for mild to moderate OA pain & inflamm -efficacy may increase as treatment continues |
|
|
What are the NSAID usage guidelines for use in chronic therapy?
|
Enhance patient response in a multi-modal program with:
-diet & exercise to control weight -physical therapy -chondro-protective agents (disease-modifying drug, nutraceuticals) |
|
|
What is an example of a nutraceutical?
|
Oral disease-modifying osteoarthritis drugs (DMOADs)
|
|
|
What is the claim related to use of oral DMOADs?
|
Prevent, reduce or reverse OA-related cartilage change
|
|
|
What are the 4 effects of oral DMOADs that help prevent, reduce or reverse OA cartilage damage?
|
1) Appear to have + effect on cartilage matrix
2) Enhance hyaluronic acid production by synovial membrane 3) inhibit catabolic enzymes in OA joints 4) Encourage normalizization of synovial fluid & cartilage matrix |
|
|
What is the downfall of nutraceuticals?
|
lack of regulatory oversight
-50 products (glucosamine, chondritin sulfate or combo products)= 84% were below acceptable potency AND many of the products contained < 50% of stated label amounts |
|
|
What are 6 agent used for pain reduction?
|
1) Opioids
2) Alpha-2 agonists 3) Cold, heat 4) Muscle relaxants 5) Gabapentin 6) Amantidine |
|
|
What are 8 opioid analgesics?
|
1) Morphine
2) Oxymorphone 3) Hydromorphone 4) Meperidine 5) Fentanyl 6) Butorphanol 7) Buprenorphine 8) Tramadol |
|
|
What opioid can be used as an epidural?
|
Morphine
|
|
|
What is the method of action of methadone as a pain reducer?
|
NMDA antagonist activity
|
|
|
What is the mechanism of action of tramadol?
|
Mu opioid receptors and decreased reuptake of NEpi and serotonin
|
|
|
What is one se of butorphanol (torbugesic) for pain management?
|
Relief of pain in CATs
-major or minor trauma -pain associated w/ surgical procedures |
|
|
How many times can you repeat the butorphanol administration to cats?
|
4 times for up to 2 days
|
|
|
What is the onset and duration of buprenorphine?
|
High receptor affinity
-slow onset= 40 minutes -long duration= 8 hours |
|
|
What is a unique method of administration of buprenorphine?
|
Transmucosal administration
|
|
|
What is an alpha-2 agonists used for pain reduction?
|
Dexmedetomidine
-sedation -preanesthetic -dose w/ opioids |
|
|
What are 6 agent used for pain reduction?
|
1) Opioids
2) Alpha-2 agonists 3) Cold, heat 4) Muscle relaxants 5) Gabapentin 6) Amantidine |
|
|
What are 8 opioid analgesics?
|
1) Morphine
2) Oxymorphone 3) Hydromorphone 4) Meperidine 5) Fentanyl 6) Butorphanol 7) Buprenorphine 8) Tramadol |
|
|
What opioid can be used as an epidural?
|
Morphine
|
|
|
What is the method of action of methadone as a pain reducer?
|
NMDA antagonist activity
|
|
|
What is the mechanism of action of tramadol?
|
Mu opioid receptors and decreased reuptake of NEpi and serotonin
|
|
|
What is one se of butorphanol (torbugesic) for pain management?
|
Relief of pain in CATs
-major or minor trauma -pain associated w/ surgical procedures |
|
|
How many times can you repeat the butorphanol administration to cats?
|
4 times for up to 2 days
|
|
|
What is the onset and duration of buprenorphine?
|
High receptor affinity
-slow onset= 40 minutes -long duration= 8 hours |
|
|
What is a unique method of administration of buprenorphine?
|
Transmucosal administration
|
|
|
What is an alpha-2 agonists used for pain reduction?
|
Dexmedetomidine
-sedation -preanesthetic -dose w/ opioids |
|
|
What are 3 anti-inflammatories used for feline pain management?
|
1) Meloxican
2) Prednisolone 3) Robenacoxib (new) |
|
|
What is the definition for steady state plasma drug concentrations?
|
When drug input = drug elimination (metabolism, distribution, excretion)
|
|
|
When is 50% of steady state plasma drug concentrations reached in terms of half-life?
|
1 half life
75% at 2 half lives 87.5% at 3 half lives |
|
|
How can you decrease the amount of time for a maximum response of a drug to occur?
|
A loading dose
|
|
|
What are 4 drugs used for CRI surgical analgesia?
|
1) Morphine
2) Lidocaine 3) Ketamine 4) Dexmedetomidine |
|
|
What are 3 other CRI drugs?
|
1) Fentanyl
2) Hydromorphone 3) Dexmedetomidine CRI dose |
|
|
How do you administer small amounts of drugs via CRI?
|
syringe pumps
|
|
|
Tramadol is a synthetic derivative of _____.
|
Codeine
|
|
|
What is the mode of action of tramadol? When is it used for analgesia?
|
Weak mu-opioid agonist
-useful alone or as adjunct -moderate to severe pain |
|
|
What are 4 advantages of tramadol?
|
1) Low abuse potential
2) No respiratory or CV effects 3) Little effect on GI motility 4) Low incidence of adverse effects |
|
|
Tramadol is best when used simulataneously with ______.
|
NSAID
|
|
|
What is the disadvantage of tramadol?
|
Short elimination half-life requires frequent dosing
|
|
|
What is Gabapentin? MOA?
|
Anticonvulsant
MOA: analog of GABA the chief inhibitory neurotransmitter -mechanism unclear -useful in central sensitization as an adjunct |
|
|
How is Gabapentin implicated in pain modulation?
|
Regulates neuronal excitability throughout the nervous system & disrupts GABAergic signaling
|
|
|
When is Gabapentin used for chronic pain?
|
Neuropathic pain or refractory chronic pain
|
|
|
Gabapentin is most beneficial as a part of ________ treatment including NSAIDs.
|
Multimodal
|
|
|
What is Amantadine?
|
Antiviral drug used in parkinson's disease
|
|
|
What is the MOA of amantadine?
|
NMDA receptor antagonist: no analgesia alone!!
-reduces central sensitization & enhances opioid sensitivity -useful as adjunct |
