Pain Management

Front 1

What are the clinical signs of pain?

Back 1

Vocalization, depression, anorexia, tachypnea, tachycardia, abnormal blood pressure, pale mucous membranes, aggression, abnormal postures, dilated pupils

Front 2

what are the signs of abdominal pain?

Back 2

"praying" or "play bowing" position, hypersalivation, inability to lay down or sleep

Front 3

What are the does a vet tech need to be able to do concerning pain?

Back 3

observe, interpret, think critically

Front 4

how often should pain be evaluated?

Back 4

every 30 minutes though critical phase and every 4-6 hours throughout hospitalization

Front 5

What is the difference between dysphoria and pain?

Back 5

dysphoria cant be calmed or soothed

Front 6

Is the sensation of pain different for dogs and cats?

Back 6

no all mammals process pain the same

Front 7

what are the 3 phases of nociception?

Back 7

transduction, transmission, and modulation

Front 8

how is pain stopped at the transduction phase?

Back 8

by local anethesia

Front 9

how is pain stopped at the transmission phase?

Back 9

with opiods

Front 10

how is pain stopped at the modulation phase?

Back 10

with a epidural

Front 11

does nociception occur in the state of unconsciousness?

Back 11

yes

Front 12

what is the wind-up phenomenon?

Back 12

when an animal is no longer in pain but response as though it is in an exaggerated manner

Front 13

how can we make the animal more comfortable?

Back 13

clean cage, comfort with blankets or toys petting and a soothing voice, and take the animal out of the cage whenever you have to do anything to the animal

Front 14

what are the principles of administering analgesia?

Back 14

preemptive analgesia, multimodal, match analgesia, maintain a plane once pain control is established, don't allow the medicine to wear off completely before giving another dose

Front 15

what is the best way to prevent pain?

Back 15

treat pain before it exisits

Front 16

what are the benefits of preventive analgesia?

Back 16

prevents hypersensitization at spinal cord, lowers sedation and anesthetic requirements, minimizes detrimental effects of pain

Front 17

what is multimodal analgesia?

Back 17

drug combinations often used to produce better pain relief

Front 18

what is the benefit of multimodal analgesia?

Back 18

reduces side effects, allows lower doses of individual agents, reduces amount of gaseous anesthetic required for a procedure, interrupts pain at various points

Front 19

how do we match analgesics?

Back 19

based on dosage and duration of action, matches degree of expected surgical pain

Front 20

How do you maintain the analgesic plane?

Back 20

dosing at regular intervals

Front 21

how long should patients be on postoperative analgesia?

Back 21

3-4 days for soft tissue procedures and 1 week for orthopedic procedures, taper medications carefully , additional analgesia if pain persists

Front 22

what is the ultimate criteria of analgesia therapy?

Back 22

pain relief

Front 23

what is the analgesia plan for each patient?

Back 23

maximize pain control, maintain patient on a plane, and reduce unwanted side effects

Front 24

what are NSAIDS?

Back 24

nonsteroid anti-inflammatory drugs

Front 25

what are commonly used NSAIDS?

Back 25

Rimadyl, Metacam, Duramaxx, Zubrin

Front 26

What are the precautions for patients on NSAIDS?

Back 26

blood pressure, renal function, liver function, no bleeding abnormalities, no gastric ulcers, no other NSAIDs, corticosteroids, or aspirin

Front 27

why are NSAIDs used as a take home analgesia?

Back 27

readily available, inexpensive, provide long lasting pain relief, convenient

Front 28

how do local anesthetics work?

Back 28

disrupt neural transmission

Front 29

what are the routes of administration for local anesthetics?

Back 29

topical, local infiltration, dental nerve block, joint space, pleural space, epidural nerve block, transdermal, IV

Front 30

what does an epidural nerve block?

Back 30

caudal half of the body

Front 31

types of opioids

Back 31

mu receptors, kappa receptors, sigma receptors

Front 32

what do mu receptors control?

Back 32

sedation, analgesia, and respiratory depression

Front 33

what do kappa receptors control?

Back 33

sedation and analgesia

Front 34

what do sigma receptors control?

Back 34

dysphoria, excitement, restlessness, and anxiety

Front 35

how are opioids classified?

Back 35

agonists or antagonists

Front 36

what are the most common opioids?

Back 36

morphine, hydromorphine, oxymorphone, and fentanyl

Front 37

how are opioids metabolized?

Back 37

by the liver and excreted by the kidneys

Front 38

what are the routes of administration for opioids?

Back 38

IV, IM, epidural, oral, transcutaneous

Front 39

what are the properties of morphine sulfate?

Back 39

used for severe pain, pure agonist, low costing, causes vomiting and systemic hypotension

Front 40

what are the properties of hydromorphone?

Back 40

used for severe pain, pure agonist, similar to morphine, fewer side effects than morphine

Front 41

What are the properties of fentanyl?

Back 41

used for severe pain, pure agonist, extremely potent synthetic, rapid onset, short duration when given IM or IV

Front 42

what are the properties of buprenorphine?

Back 42

used for moderate to severe pain in cats, primary used for take home medicines, partial mu agonist, longer than morphine

Front 43

what are the properties for butorphanol?

Back 43

used for mild pain, kappa agonist, and mu antagonist, reverse adverse reactions associated with morphine, given SQ IM IV

Front 44

what are the properties of Naloxone Hydrochloride?

Back 44

opioid reversal, antagonist, rapid reversal of sedation

Front 45

What are the properties of tramadol?

Back 45

used for moderate pain, synthetic drug, fewer side effects than opioids, can be used long term at home, orally administered

Front 46

what does xylazine cause in cats?

Back 46

vomiting

Front 47

what are examples of alpha 2 agonists?

Back 47

xylazine, domitor, and dexdomitor

Front 48

what are the advantages of alpha 2 agonists?

Back 48

provide pain relief, works with opioids

Front 49

what is kitty magic?

Back 49

an alpha 2 agonist, an opioid, and ketamine

Front 50

what is the MLK combination?

Back 50

morphine (opioid) lidocaine (local anesthetic) ketamine (analgesia)

Front 51

what are nonpharmacological ways to treat pain?

Back 51

thermotherapy, massages, therapeutic exercises, aquatic therapy, electrical stimulations, acupuncture

Front 52

what are the signs of pain in large animals?

Back 52

stop eating, appear lethargic, stand hunched back (ruminants), stretch out in abnormal posture (horses) grind teeth (horses) "dog sit" (foals)

Front 53

what NSAIDs are used in large animals?

Back 53

phenylbutazone (bute) and flunixin meglumine (banamin)

Front 54

what opioids are used in large animals?

Back 54

butorphanol is most common, morphine, buprenorphine, and fentanyl

Front 55

what is sedation?

Back 55

state of calm or drowsiness

Front 56

what is tranquilization?

Back 56

state of relaxation and reduced anxiety