Chapter 18: Drugs for the Control of Pain

Question 1

What is Nociceptive pain?

Answer 1

pain d/t injury to tissues

Question 2

What are two types of nociceptive pain?

Answer 2

• somatic: sharp sensation (localized
• Visceral: Dull, throbbing, aching (form internal organ inflammation or damage

Question 3

What is Neuropathic Pain?

Answer 3

• dt injury to nerves
• burning, shooting, numbing

Question 4

What are some examples of Neuropathic pain?

Answer 4

• carpal tunnel syndrom
• Degenerative disk disease
• Diabetic retinopathy
• interactable cancer pain
• phantom limb pain
• Postsurgical pain
• sciatica

Question 5

What are some nonpharmacologic therapies for pain?

Answer 5

• acupuncture
• biofeedback
• massage
• heat or cold
• meditation/prayer
• relaxation therapy
• art or music
• guided imagery
• chiropractic manipulation
• hypnosis
• physical therapy
• therapeutic physical touch
• TENS
• natural agents applied to skin, producing warming sensation

Question 6

What treatment is available for intractable cancer pain?

Answer 6

• radiation or chemo
• Relieving nerve stimulation
• surgery
• nerve block

Question 7

What are Opioids?

Answer 7

Natural or synthetic morphine-like substances responsible for reducing moderate to servere pain

Question 8

which opioid receptors are most important for pain management?

Answer 8

mu and kappa receptors

Question 9

What do Opioid agonist drugs do?

Answer 9

stimulate mu and kappa receptors

Question 10

What are some examples of opioid agonist drugs?

Answer 10

Morphine, OxyContin, Percocet

Question 11

What do opioid antagonist drugs do?

Answer 11

• block mu and kappa receptors
• reverse symptoms of addition, toxicity, and OD

Question 12

What is an example of an opioid antagonist drug?

Answer 12

Narcan

Question 13

What do Opioids with mixed agonist-antagonist activity do?

Answer 13

• stimulate opioid receptor, thus causing analgesia
• withdrawal symptoms and side effects not as intesnse as those of opioid agnosits

Question 14

What is an example of a mixed agonist-antagonist?

Answer 14

pentazocin

Question 15

What is the treatment for Opioid dependence?

Answer 15

• switch from IV and inhalation opioids to methadone
• may be needed for many months to years
• does not cure but avoids withdrawal symptoms
• allows pt to be productive

Question 16

What are some newer treatments for opioid dependence?

Answer 16

• Early treatment: buprenophrine: mixed opioid agonist-antagonist
• admin sublinqual or transdermal
• Later maintenance: bunavail, suboxone, and zubsolv contain bothe buprenorphine and naloxone

Question 17

What are 4 steps for opioid therapy in the role of a nurse?

Answer 17

1. Assess potential for opioid dependency
2. Assist with activity
3. monitor urine output for retention
4. monitor patients bowel habits for constipation

Question 18

What are non-opioid analgesics used for?

Answer 18

• used for fever, inflammation, and analgesia
• used for mild or moderate pain associated with inflammation

Question 19

What are examples of non-opioid analgesics?

Answer 19

• NSAIDs
• acetaminophen
• a few centrally acting drugs

Question 20

What is the role of the Nurse for nonopiod analgesics?

Answer 20

• monitor pts condition and provide education
• assessment for hypersensitivity, bleeding disorders
• assessment for gastric ulcers, severe renal/hepatic disease, pregnancy
• obtain lab tests on renal liver function
• pain assessment

Question 21

What is the prototype drug for NSAIDs

Answer 21

ibuprofen

Question 22

what is the MOA of ibuprofen

Answer 22

to inhibit cyclooxygenase and prvent formation of prostaglandins

Question 23

What is the primary use for iburprofen?

Answer 23

for mild or moderate pain and to reduce inflammation

Question 24

What are the adverse effects of NSAIDs

Answer 24

GI upset, acute renal failure

Question 25

W/hat is the prototype drug for selective COX-2 inhibitors?

Answer 25

celecoxib

Question 26

What is the MOA of celecoxib

Answer 26

similar to the NSAID

Question 27

What is the primary use for celecoxib?

Answer 27

to relieve pain, fever, and inflammation

Question 28

What are the adverse effects of celecoxib?

Answer 28

mild and related to GI system

Question 29

What are the prototype drugs for centrally acting nonopiod analgesics

Answer 29

acetaminophen and tramadol

Question 30

What is the MOA for acetaminophen

Answer 30

to treat fever at the level of the hypothalamus; causes dilation of peripheral blood vessels, enabling sweating and dissipation of heat

Question 31

What is the primary use of acetaminophen?

Answer 31

treatment of fever and to relieve pain

Question 32

What are the adverse effects of acetaminophen

Answer 32

uncommon with therapeutic doses

Question 33

what is the MOA of tramadol?

Answer 33

weak opioid activity

Question 34

What is the primary use of tramadol?

Answer 34

as centrally acting analgesic

Question 35

what are the adverse effects of tramadol

Answer 35

CNS, GI, and CV effects

Question 36

What type of antimigraine drugs are there

Answer 36

• Triptans
• Ergot alkaloids
• NSAID

Question 37

what are triptains and how do they act?

Answer 37

• serotonin agonists
• act by constricting certain intracranial vessels

Question 38

What are Ergot alkaloids and how do they act?

Answer 38

• interact with adrenergic, dopaminergic, and serotonin receptors
• act as vasoconstrictors
• terminate ongoing migraines

Question 39

What NSAID medication treats mild migraine?

Answer 39

ibuprofen

Question 40

What is the MOA of Ergot alkaloids?

Answer 40

to promote vasoconstriction

Question 41

What is the primary use for Ergot alkaloids?

Answer 41

to terminate ongoing migrains

Question 42

What are the Adverse Effects for Ergot Alkaloids?

Answer 42

• GI upset
• weakness in the legs
• myalgia
• numbness and tinglin in fingers and toes
• angina-like pain, tachycardia