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39 Cards in this Set
- Front
- Back
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Acute pain |
Usually predictable common after surgery, trauma and medical problems typically resolves as it heals lasts less than 30 days
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Chronic malignant pain |
associated with progressive disease that is potentially life limiting can have elements of acute pain when tissue damage continues from tumor infiltration |
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Chronic non-malignant pain |
pain not associated with malignant disease lasting greater than 6 months or beyond the healing period associated with depression, insomnia, weight loss, etc. |
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tolerance |
a state in which a larger dose is required to produce the same response that could formerly by elicited by a smaller dose |
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physical dependence |
a state in which a withdrawal syndrome will occur if the drug is stopped abruptly or if dose is rapidly reproduced |
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addiction |
compulsive need for and use of a habit forming substance characterized by tolerance and well-defined and physiological symptoms upon withdrawal |
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clinical presentation of somatic nociceptive pain |
arising from skin, bone, joint, muscle or connective tissue well-localized pain dull, aching, throbbing pain |
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clinical presentation of visceral nociceptive pain |
arising from internal organs (large intestine or pancreas) referred or well-localized pain deep, aching, squeezing pain |
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physical signs associated with acute pain |
excessive cardiac activity (increased heart rate) increased respiratory rate hypertension facial expression diaphoresis (increased sweating) |
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5 pain assessment questions |
palliative factors/ provocative factors (what makes the pain better/worse?) quality radiation severity temporal factors |
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somatic therapies for pain |
heat/cold, exercise, massage/relaxation TENS, acupuncture, ultrasound surgery, radiation, nerve block |
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aspirin MOA |
inhibits prostaglandin synthesis inhibit platelet cyclooxygenase |
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aspirin adverse effects |
GI upset, GI ulcers, GI bleeding |
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aspirin therapeutic effects |
antipyretic anti-inflammatory analgesic anti-platelet |
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acetaminophin MOA |
inhibits COX in the brain but not at the peripheral sites |
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acetaminophen adverse effects |
liver damage |
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acetaminophen therapeutic effects |
analgesic, antipyritic |
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non-steroidal anti-inflammatory drugs (NSAIDS) MOA |
inhibits prostaglandin synthesis via the inhibition of both COX 1 and COX 2 |
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NSAIDS adverse effects |
renal dysfunction, GI upset |
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NSAIDS therapeutic effects |
analgesic, antipyretic, anti-inflammatory |
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ceiling effect |
partial opioid agonists, NSAIDS
at a certain level of drug administered, the effects don't get stronger |
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cautions of aspirin |
allergy, bleeding disorders or in combination with other anti platelets or anticoagulants, children under 16 for viral infection, pregnancy, history of GI disease, renal dysfunction |
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cautions of acetaminophin |
hepatic impairment, heavy alcohol users |
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cautions of NSAIDS |
allergy, combination with anticoagulants, decreased hepatic function, pregnancy |
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maximum dose of acetaminophen |
acute- 4 grams chronic- 2 grams hepatic impairment or heavy alcohol users ≤ 2 grams/day
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advantages of COX2 inhibitors |
selectively inhibit COX 2, preserves protective effects of prostaglandins on GI mucosa |
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disadvantages of COX2 inhibitors |
increased risk of adverse cardiac events |
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opioid analgesics MOA |
binds to opiate receptors in the CNS altering the perception and response to pain |
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full agonist |
sits on receptor and elicits a response |
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partial agonist |
sits on receptor and results in activity that is less than full agonist
can act as antagonists in the presence of full agonists |
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antagonist |
sit on receptor and blocks a response |
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morphine like analgesics |
morphine, hydromorphone, oxycodone, codein, hydrocodone |
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toxicity associated with meperidine |
active metabolite can cause tremor, muscle twitching and seizures |
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toxicity associated with the use of meperidine |
active metabolite of meperidine can cause fatal seizures when converted by the liver |
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rationale for the use of methadone in narcotic treatment programs |
it has a delayed onset and long duration of action no highs or lows |
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advantages of partial opioid agonists |
less additive and less respiratory depression |
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disadvantages of partial opioid agonists |
ceiling effect may precipitate withdrawal in opioid tolerant patients |
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utility of opioid antagonists |
used for severe withdrawal reactions rapidly reverses opioid induced respiratory depression |
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side effects associated with opioid use |
respiratory depression, constipation, itching, nausea/vomiting, drowsiness/sedation |
