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;
23 Cards in this Set
- Front
- Back
|
Types of pain
|
Nocioceptive
Neuropathic Visceral |
|
|
Acute pain vs. chronic
|
In direct opposition to acute pain, chronic pain has/is...
no useful function exacerbated with activation/movement, unresponsive to many forms of tx opioids may not be effective secondary gains are present/worth it (e.g. being waited on hand and foot) signals body to go into a vegetative/depressed state. |
|
|
Some types of pharm therapy used to tx pain
|
NSAIDS
Tricyclics Anticonvulsants Opioids |
|
|
Best antidepressant for pain
|
Amitryptiling (tricyclic)
Other examples - imipramine, desipramine, doxepin, nortriptyline, cymbalta (Duloxetine-SSRI) |
|
|
Antidepressant mech of action
|
Inhib reuptake of NE and some inhib 5HT reuptake (and this helps with pain)
|
|
|
Dosage of antidepressants for pain
|
25-100 mg/day
|
|
|
SE of using antidepressants for pain
|
sedation is a big one, but many pain pts are insomnic anyway
n/v, constipation, orthostatic HypoTN, cardiac arryth, urinary retention, sexual dysfunc, weight gain. |
|
|
Anticonvulsants - most useful for...
|
Nerve pain!!!
|
|
|
Anticonvulsants - mech of action
|
Usually blocking sodium channels
|
|
|
Anticonvulsants - Examples
|
Neuropathic pain - Gabapentin, pregablin, carbamazepine, topamax, lamotrigine
Phenytoin |
|
|
Important gabapentin SE
|
Used in the elderly, but memory loss (short term) is an issue
|
|
|
Phenytoin SE
|
gingival hyperplasia
|
|
|
Carbamazepine SE
|
BM suppression.
|
|
|
Strength compared to morphine - Oxycodone
|
1:1
|
|
|
Strength compared to morphine - Fentanyl
|
70-100X
|
|
|
Strength compared to morphine - Methadone
|
1-12X
|
|
|
Strength compared to morphine - Dilaudid (Hydromorphone)
|
7.5X
|
|
|
Strength compared to morphine - Demerol
|
1/10 as strong.
|
|
|
False statements abt opioids
|
Chronic opioid therapy for chronic non-malignant pain is standard treatment
All pain is opioid responsive Short acting opioids are better for pain If one opioid is good, two are better IV, IM is better than PO. “I’ll just give him a few percocets” |
|
|
Benefit of intrathecal administration
|
Can reduce admin dose 300X and less SE.
|
|
|
Use celiac plexus block for...
|
abdominal pain
|
|
|
For effective pain mgmt, you wanna reduce their pain scale (0-10) by...
|
2
|
|
|
Pseudoaddiction
|
Due to an undertreatment of pain
Pt requests more drug or runs of out meds early. This behavior stops when adequate pain relief is met. Hard to discern from a true addiction. |
