Pharmacology - Pain Mgmt

Question 1

Explain the MOA behind Fentanyls rapid onset

Answer 1

Fentanyl is very lipophilic, and rapidly crosses the BBB into the CNS, resulting in rapid onset ( appx 30 sec-min)

Question 2

Fentanyl is _____ more potent than morphine.

Answer 2

80-100 x

Question 3

Explain mechanism of low dose Ketamine for pain

Answer 3

Ketamine’s MOA is dose dependent

• Low dose = analgesia
• High dose = dissociative anesthetic

Question 4

For the patient who has a hx of opioid abuse or chronic pain experiencing acute pain (like from an extremity fracture), it is (appropriate/inappropriate) to treat with opioids.

Answer 4

appropriate

- it is an acute injury

Question 5

The geriatric may have difficulty receiving adequate analgesia. Why?

Answer 5

Expression:

• cognitive difficulties expressing themselves
• “stoic” manner

Physical signs:

• Other meds may mask “signs” of objective pain like tachycardia
• May have changes to their metabolism of meds

Question 6

Sedation and analgesia may overlap. Why?

Answer 6

Sedation meds will reduce agitation 2/2 pain. It will increase cooperation to interventions.