Nc 3 Pain

Front 1

Nociception
Transduction Stage

Back 1

1st phase - injury releases biochemical mediators, movement of ions; NSAID can block production of prostaglandins; local anesthetic cand block ion movement

Front 2

Nociception
Transmission Stage

Back 2

1st segment-movement from perpheral nerve fibers to dorsal horn. C fibers dull aching pain A delta fibers sharp localized pain
2nd segment spinal cord ascension via spinal thalamus tracts to brain stem -opoids block release of neurotransmitters
3rd segment transmission of signals between thalamus to somatic sensory organ

Front 3

Nociception
Perception Stage

Back 3

client becomes aware of pain. distration techniques, guided imagery

Front 4

Nociception
Modulation Stage

Back 4

descending system releases endogenous opoids, serotonins, norephrinine.
Use tricyclic antidepressants which inhibit the reuptake of norepinephrine and serotonin

Front 5

Nonnarcotic Analgesics

Back 5

act on peripheral system at pain receptor sites
aspirin, acetaminophen, ibuprofen, naproxen
mild to moderate pain

Front 6

NSAID

Back 6

nonsteroidal antiinflammatory drugs. All have an analgesic effect, antipyretic, & antiinflamatory actions.
ASA, ibuprofens, Nuprin, Advil, Medipren, naproxen (Aleve) Aspirin is a salicylate NSAID

Front 7

Acetaminophen

Back 7

not an NSAID. does not have antiinflammatory properties of aspirin. OD toxic to hepatic cells. Therapueic serum range is 5 - 20 mcg/ml.
NVD & abd pain early s/s of hepatic damage. Prescription meds containing tylenol: darvocet-N100, Loritab, Percocet, Vicodin

Front 8

Aspirin

Back 8

Bayer, Bufferin, Ecotrin (enteric coated), Anacin (has caffeine), Alka Seltzer. <12 yrs old- Reyes syndrome.
analgesic, antipyretic, antiinflammatory, lowers platelet aggregation. releives pain by inhibiting the enzyme cyclooxygenase

Front 9

cyclooxygenase

Back 9

enzyme needed for biosynthesis of prostaglandin.
Cox-1 protects stomach lining, regulates blood platelets (promotes clotting)
Cox-2 triggers pain & infamation at the injured site. When Cox 1 inhibited protection to stomach lining is decreased, fever, pain,& blood clotting is also decreased. Celebrex, Mobic & Relafen only block Cox 2

Front 10

foods containing salicylates

Back 10

prunes, raisins, paprika, licorice

Front 11

Narcotic Analgesics

Back 11

mod to sev pain. act on CNS. supresses pain impulses, resperations, coughing by action on medulla. All have antitussive effect except meperidine (Demerol)

Front 12

Vicoprofin

Back 12

mod to sev pain. combination drug: hydrodcodone & ibuprofen (opoid & NSAID)

Front 13

fentanyl (Duragesic)

Back 13

25,50,77,100mg/hr
transdermal analgesic
max levels in 24 hrs
available also for IM or IV
more potent than morphine

Front 14

meperidine (Demerol)

Back 14

CSSII
synthetic
effective in GI procedures
not antitussive
not for long term use
600mg in 24 hrs no longer than 72 hrs.
metabolized in liver to an active metabolite.

Front 15

hydromorphone (Dilaudad)

Back 15

CSSII
semisynthetic
6x more potent than morphine with fewer hypnotic effects & lower GI distress
Faster onset & shorter duration than morphine.
when given IV dilute with 5ml sterile H2O

Front 16

Morphine

Back 16

CSSII
acute pain from AMI, cancer, dyspnea from pulmonary edema. can be preop med.
Antidote: naloxone (Narcan)
MS Contin duration of 8 - 12 hrs

Front 17

Narcotic Agonist-Antagonists

Back 17

naloxone (Narcan)is added to a narcotic
pentazocine (Talwin)
butorphanol tartrate (Stadol)
buprenorphine (Buprenex)
nalbiphine hydrochloride (Nubain)

Front 18

Narcotic Antagonists

Back 18

antidotes, reverse CNS & respiratory depression.
naloxone (Narcan), naltrexome hydrochloride (ReVia), nalmefene (Revex)

Front 19

Noradrenergic drug agonist

Back 19

modulate the ascending pain signal from the dorsal horn