Physiological Basis Od Pain Managemenr Approaches

Question 1

What negative impact does unrelieved pain have on an individual?

Answer 1

Quality of life, acute pain become chronic and depression

Question 2

What is the analgesic ladder?

Answer 2

Forms the basis of many approach for the use of analgesics (drug acting to relieve pain)

Question 3

What 3 steps does the analgesic ladder consist of?

Answer 3

Step 1 non opioid - NSAIDS including paracetamol/ibuprofen
Step 2 weak opioid - codeine
Step 4 strong opioid - morphine

Question 4

What is an NSAID?

Answer 4

NSAIDS manages pain by inhibiting the production of COX by blocking the release prostaglandins (made up of COX)

Question 5

What are prostaglandins?

Answer 5

Formed by an enzyme called cyclooxygenase (COX)

Question 6

If adequate pain relief is not achieved with non opioids, then a weak opioid will be given, such as?

Answer 6

Codeine

Question 7

What effect will opioids such as codependent have when they interact with opioid receptors in the spinal cord?

Answer 7

Inhibit secretion of substance P (neurotransmitter) and blocks substance P receptors and reduce pain

Question 8

Where do opioid receptors bind too?

Answer 8

Brain, spinal cord and elsewhere

Question 9

When opioid receptors are activated, they help to block?

Answer 9

The brains ability to perceive pain

Question 10

What possible routes of administration of strong opioids are there?

Answer 10

Orally, subcutaneous, IV, Intramuscular and topical

Question 11

What are adjuvant drugs?

Answer 11

Not typically used for pain but helpful in its management Eg. Antidepressants and muscle relaxants

Question 12

How do antidepressants reduce pain?

Answer 12

Enhancing activity in the descending inhibitory pathways which reduces pain

Question 13

A common side effect if opioid administration is?

Answer 13

Constipation

Question 14

NSAIDS reduce pain by?

Answer 14

Inhibiting the synthesis of prostaglandins