Pharm T4 Ch10

Front 1

medications to relieve pain.

do not cause loss of consciousness.

"painkillers"

Back 1

analgesics

Front 2

an unpleasant sensory and emotional experience associated with actual or potential tissue damage. whatever the patient says it is. exits when the patient says it exists.

Back 2

pain

Front 3

sudden onset. usually subsides with treatment of underlying cause.

Back 3

acute pain

Front 4

persistent or recurring pain. lasts at least 3- 6 months, can be difficult to treat.

Back 4

chronic pains

Front 5

direct stimulation of receptions

Back 5

nociceptive pain

Front 6

localized, dull ache, throbbing pain.

Back 6

somatic

Front 7

burn, cut, arthritis, fracture.

Back 7

somatic pain

Front 8

poorly localized, damage to internal organs, abdominal muscles, deep cramping, or sharp, squeezing, can "refer" to a distal site.

Back 8

visceral pain

Front 9

kidney stones, IBS, angina accompanying an MI, gallstones, appendicitis

Back 9

visceral pain

Front 10

injury to peripheral nerves or CNS

Back 10

neuropathic pain

Front 11

quick pain that subsides, sharp, stinging, burning pain

Back 11

superficial pain

Front 12

continued sensation after the loss of a limb or body part

Back 12

phantom pain

Front 13

tissue injuries cause the release of ____ .

Back 13

bradykinin

Front 14

peptide that cause blood vessels to dilate in order for blood to flow to damage tissue.

Back 14

bradykinin

Front 15

most common and well described therapy. use of gate analogy to describe how impulses from damaged tissues are sensed in the brain. many current pain management strategies aim at altering this system.

Back 15

gate theory of pain transmission

Front 16

spinal cord entry or "___". regulates the flow of sensory impulses to the brain. closing the __ stops ____.

Back 16

gate; the dorsal horn; gate; impulses

Front 17

when no impulses are transmitted to higher centers in the brain,____.

Back 17

there are no pain perception

Front 18

patients are able to self- medicate by pressing a button on a ___ infusion pump.

Back 18

patient-controlled analgesia; PCA

Front 19

PCA pumps may be pushed by______ for pain control in hospice patients who are unable to push the button themselves. Parameters are entered____ .

Back 19

another specifically designated person; to prevent overdosing

Front 20

pt may have a steady infusion plus_____ for breakthrough.

Back 20

small boluses;

Front 21

when well- meaning family members have administered too much of the opiod drug, which could result in death.

Back 21

PCA by proxy

Front 22

addition of an adjuvant drug which increases the efficacy of another drug causes a___.

Back 22

Synergistic effects

Front 23

assist the primary drugs in relieving pain in order to cause a synergistic effect

Back 23

adjuvant drug (NSAIDS)

Front 24

adjuvant drugs for neuropathic pain

Back 24

amitriptyline( antidepressant)

gabapentint( neurontin)

pregabalin ( antivonculsants)

Front 25

very strong pain reliever. natural and synthetic drugs that bind to the ___ receptors to relieve pain

Back 25

opioid drugs; opiate

Front 26

opioid analgesics drugs (4)

Back 26

codeine sulfate,

hydromorphone,

oxycodone,

morphine sulfate

Front 27

___is the pain relief standard

Back 27

morphine sulfate

Front 28

less dependency potential, cause a weaker neurologic response than a full agonist

Back 28

agonist- antagonists

Front 29

also called partial agonist or mixed agonist

Back 29

agonist-antagonists

Front 30

analgesia will not improve, even with higher doses

Back 30

opioid ceiling effect

Front 31

reverse the effects of these drugs on pain receptors

Back 31

antagonists

Front 32

main use: to alleviate moderate to severe pain.

Back 32

opioid analgesics

Front 33

interactions with opioids:

Back 33

tricyclic antidepressants (amitriptyline/Elavin), Coumadin

Front 34

adverse effects of opioid analesics

Back 34

leads to respiratory distress, diaphoresis and flushing, constipation

Front 35

a common physiologic result of chronic opioid treatment, a larger dose is required to maintain the same level of analgesia, NOT the same as the ceiling effect

Back 35

opioid tolerance

Front 36

a desire to avoid withdrawal is not____

Back 36

addiction

Front 37

psychologic dependence is classified as a ____.

Back 37

disease

Front 38

administer an opioid antagonist such as ___ to reverse toxicity or overdose.

Back 38

naloxon

Front 39

little to no anti-inflammatory effects

Back 39

non-opioid analgesics: acetaminophen (Tylenol)

Front 40

maximum daily dose for, acetaminophen, in healthy adults is ____, and for the elderly its ____.

Back 40

3000 mg; 2000mg

Front 41

acetaminophen contraindications are (2), dangerous interactions may occur with ___, or other hepatoxic drugs

Back 41

liver dysfunction, possible liver failure; alcohol

Front 42

Alcohol and hepatotoxic drugs taken with acetaminophen increase the risk of_____ and can be severe enough to require_____.

Back 42

significant cellular liver damage; a transplant, or can lead to death.

Front 43

overdose, whether intentional or resulting from chronic unintentional misuse causes____, hepatotoxicity.

Back 43

hepatic necrosis

Front 44

recommended antidote for acetaminophen toxicity or overdose is ____ regimen, rotten egg taste, disguise flavor with a ____.

Back 44

acetylcysteine (Muccomyst); soda

Front 45

herbal product used to treat migraine headaches, menstrual cramps, inflammation, and fever.

Back 45

feverfew

Front 46

withhold dose and contact physician if there is a decline in the patient's condition or if vital signs are___, especially if respiratory rate is ___

Back 46

abnormal; less than 10 to 12 breaths/min

Front 47

If opioids are to be used for an extended period, daily_____ may be ordered. A pain record helps establish the efficacy of dosing amounts or scheduling, or the need for breakthrough dosing.

Back 47

docusate (Colace)

Front 48

follow proper guidelines for IV administration, including___, rate of ____.

Back 48

dilution; administration

Front 49

____ is a common adverse effect of opioids and may be prevented with adequate fluid and fiber in take

Back 49

constipations

Front 50

patients should be instructed to change positions slowly to prevent

Back 50

possible orthostatic hypotension

Front 51

____ are sometime chosen for patients who have a history of opioid addiction.

Back 51

agonist-antagoinst

Front 52

agonist antagonist drugs

Back 52

buprenorphrine (Buprenex), butorphanol (Stadol), nalbuphine (Nubain), pentazocine (Talwin).