Analgesics Part 1

Question 1

Steps of Nociception

Answer 1

Transduction, Transmission, Perception of pain, Modulation

Question 2

Definition of Pain

Answer 2

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 3

Pain Threshold

Answer 3

Level of stimulus needed to produce a perception of pain. (Measure of the physiological response of the nervous system)

Question 4

Pain Tolerance

Answer 4

Amount of pain a person can endure without it interfering with normal function.

Question 5

Pain tolerance is always:

Answer 5

Subjective and Patient-specific

Question 6

What are the 2 classifications of pain?

Answer 6

Acute and Chronic

Question 7

What is acute pain

Answer 7

Sudden onset that is limited (It can end)

Question 8

What is Chronic pain?

Answer 8

Persistent or recurring; 3 - 6 months.

Question 9

What are the other types of pain?

Answer 9

Referred, Neuropathic, Phantom, Cancer, Central and Vascular

Question 10

What is Transduction

Answer 10

Transformation of stimuli into electrochemical energy

Question 11

What is the point of spinal cord entry?

Answer 11

Dorsal horn

Question 12

What pain-mediating chemicals are released during transduction?

Answer 12

Bradykinin, Histamine, Prostaglandins, Potassium, Serotonin, Substance P

Question 13

What happens if no impulses are transmitted to the brain?

Answer 13

There is no pain perception

Question 14

What are the two types of nociceptor fibers?

Answer 14

Small C fibres
Large A-delta fibres

Question 15

The larger number of mu receptors :

Answer 15

The less the pain is perceived

Question 16

What is Modulation

Answer 16

Neural Activity that controls pain transmission to neurons

Question 17

What are the ways to treat pain in special situations?

Answer 17

Patient-controlled analgesia(PCA)
Patient comfort vs fear of drug addiction
Opioid tolerance
Use of placebos
Recognizing opioid tolerant patients, Breakthrough pain
Synergistic effects

Question 18

What are Adjuvant drugs

Answer 18

Drugs from chemical categories other than opioids

Question 19

What is the purpose of adjuvant drugs

Answer 19

Assisting primary drugs in relieving pain

Question 20

What are some examples of adjuvant drugs?

Answer 20

NSAIDs
Antidepressants (Amitriptyline)
Anticonvulsants (Gabapentin)
Corticosteroids

Question 21

Describe the WHO Analgesic Ladder

Answer 21

1: Nonopioids with or without adjuvant meds.
2: Opioids with or without nonopioids and with or without adjuvants
3: Opioids for more severe pain with or without nonopioids or adjuvant medications

Question 22

What are opioids

Answer 22

Synthetic Drugs that bind to opiate receptors to relieve pain

Question 23

What is the Opioid ceiling effect?

Answer 23

When it reaches its maximum analgesic effect

Question 24

What are the 3 classifications of opioids

Answer 24

Agonists
Agonists-antagonists
Antagonists

Question 25

What is another name for agonists-antagonists?

Answer 25

Partial or weak agonists

Question 26

What is another name for antagonists?

Answer 26

Competitive antagonists

Question 27

What are the 3 types of opioid receptors

Answer 27

Mu, Kappa, Delta

Question 28

What are equianalgesia

Answer 28

The ability to provide equivalent pain relief by calculating dosages of different drugs or routes of admin that provide comparable analgesia

Question 29

What are the indications for opioids

Answer 29

Moderate to severe pain Often given with adjuvants to assist primary drugs with pain relief Cough Centre suppression (codeine) Treatment of diarrhea

Question 30

What are the contraindications for opioids?

Answer 30

Allergies, severe asthma

Question 31

In what cases do you exercise extreme caution when giving opioids

Answer 31

Respiratory insufficiency Elevated intracranial pressure Morbid obesity or sleep apnea Paralytic ileus Pregnancy

Question 32

What are the adverse effects of opioids?

Answer 32

CNS and respiratory depression Constipation Urinary retention Hypotension Itching rash Constricted pupils indicating possible OD.