Ch.19- Drugs used for Pain

Question 1

Pain Experience

Answer 1

An unpleasant situation that is part of a larger situation

Question 2

The 3 terms used in relationship to the pain experience are….

Answer 2

Pain perception, pain threshold, and pain tolerance

Question 3

Pain perception AKA nociception

Answer 3

An individuals awareness of the feeling or sensation of pain

Question 4

Pain threshold

Answer 4

The point at which an individual first acknowledges or interprets a sensation as being painful

Question 5

Pain tolerance

Answer 5

The individuals ability to endure pain

Question 6

Acute pain

Answer 6

Arises from sudden injury to the structures of the body . (Broken leg, appendicitis)

Question 7

Chronic pain

Answer 7

Has a slower onset and lasts longer than 3 months, does not relate to an injury ( Arthritis, back pain)

Question 8

Nociceptive pain

Answer 8

The result of a stimulus (chemical, thermal, mechanical) to pain receptors. Usually described by patients as dull and aching.

Question 9

Somatic pain

Answer 9

Originates from the skin, bones, joints, muscles, or connective tissues, (arthritis pain)

Question 10

Visceral pain

Answer 10

Originates from the abdominal and thoracic organs.

Question 11

Nociception

Answer 11

The process that a person becomes aware of the presence of pain

Question 12

4 steps in nociception

Answer 12

1. Transduction
2. Transmission
3. Perception
4. Modulation

Question 13

Neuropathic pain

Answer 13

Results from an injury to the peripheral or central nervous system (CNS)- (Phantom limb pain)

Question 14

Idiopathic pain

Answer 14

A nonspecific pain of unknown region. Common areas = pelvis, neck, shoulders, abdomen, and head.

Question 15

Analgesics

Answer 15

Drugs that relieve pain without producing loss of consciousness or reflex activity. An analgesic or painkiller is any member of the group of drugs used to achieve analgesia, relief from pain. (opiate agonists, opiate partial agonists, opiate antagonists, and prostaglandin inhibitors) - Tylenol, salicylates, NSAIDS

Question 16

Opiate receptors

Answer 16

Block pain when stimulated

Question 17

Opiates

Answer 17

Drugs that act on the same sites in the brain as morphine to stimulate analgesic effects or to block those effects

Question 18

Opiate agonists

Answer 18

For acute, moderate, to severe pain commonly associated with acute injury, postoperative pain, renal or biliary colic, MI, or cancer. May also be used to provide preop sedation and supplement anesthesia. Also reduce anxiety. IV works the fastest.

Question 19

With prolonged use Opiate agonists may cause what?

Answer 19

Drug tolerance, as well as, psychological and physical dependence.

Question 20

Drug tolerance

Answer 20

Means a patient needs larger doses to receive the same analgesic effect. May occur after to 6 weeks.

Question 21

Long term use of Opiate agonists can cause?

Answer 21

Constipation

Question 22

______ Is a stool softener that is commonly used to help with constipation.

Answer 22

Docusate

Question 23

NSAID -Tramadol may cause what side effect? Especially in elderly or debilitate patients?

Answer 23

Dark tarry stools. (bleeding)

Question 24

DO NOT administer Opiate agonists if respiration’s are below what?

Answer 24

12 per minute

Question 25

Expected side effects of Opiate Agonists

Answer 25

Light headedness, dizziness, sedation, nausea, sweating, confusion, disorientation, orthostatic hypotension, constipation

Question 26

REPORT what side effects?

Answer 26

Respiratory depression, urinary retention, overuse, or abuse

Question 27

Drug interactions of Opiate Agonists

Answer 27

CNS depressants may enhance the depressant effects

Question 28

Morphine Sulfate

Answer 28

Most commonly used Opiate Agonist drug.

Question 29

Side effects of Morphine Sulfate include:

Answer 29

Low blood pressure, Respiratory depression, urinary retention, constipation

Question 30

Fentanyl

Answer 30

Another commonly used Opiate Agonist. Strong drug that is used for strong pain control. Can be administered Parenteral (shot) or transdermal (patch). Narcan can be used to reverse the action.

Question 31

Acetaminophen doses are limited to no more than ___ in 24 hrs

Answer 31

4G. Be sure to watch for other sources of tylenol in combo products including OTC cold/allergy meds.

Question 32

Opiate Partial Agonists

Answer 32

Depend on whether an opiate agonist has been administered previously. Used for short term relief (up to 3 weeks) of moderate to severe pain associated with cancer, burns, preop analgesic, and OB surgical analgesic.

Question 33

Ceiling effect

Answer 33

Occurs when a prolonged use of a drug leads to tolerance and higher doses do not increase analgesia but DOES increase the incidence of adverse effects.

Question 34

Expected side effects of Opiate Partial Agonists

Answer 34

Clamminess, dizziness, sedation, nausea, dry mouth, sweating, and constipation.

Question 35

REPORT these side effects of Opiate Partial Agonists

Answer 35

Confusion, disorientation, hallucinations, respiratory depression, overuse, or abuse

Question 36

Drug interactions of Opiate Partial Agonists

Answer 36

CNS depressants, opiate agonists

Question 37

Opiate antagonists

Answer 37

reverse the respiratory depression, sedation, and hyotension associated with opiate agonists and opiate partial agonists.

Question 38

Commonly used Opiate antagonists

Answer 38

Narcan (naloxone) and Naltrexone (Revia)

Question 39

Narcan (naloxone) effects:

Answer 39

Return of the symptoms the narcotic was used for (pain) Increase in BP. Tremors, and hyperventilation. Reverses respiratory depression from opiates.

Question 40

Naltrexone is used for:

Answer 40

To block effects of opioids in patients in drug abuse programs, adminstered orally and has a longer duration of action, blocks feeling of euphoria and prevents opiate cravings. Also used in treatment of alcoholism.

Question 41

Salicylates

Answer 41

Can be taken to relieve pain on a long-term basis without causing drug dependence. Also used to reduce the risk of TIA'S (Stroke) as well as for patients experiencing an acute MI.

Question 42

Most common Salicylate drug:

Answer 42

Aspirin. Which is commonly Enteric coated so it does not dissolve in the stomach causing gastric irritation/bleeding. Not able to be crushed. Patients with vitamin K or bleeding disorders should not take aspirin due to the risk of bleeding.

Question 43

Toxicity effects of Salicylate drugs (Aspirin)

Answer 43

Tennitis, hearing loss, nausea, vomiting, can cause Reye's syndrome (fatal) in children.

Question 44

Nonsteroidal anti inflammatory drugs AKA NSAIDs (Aspirin like)

Answer 44

Preferred option for patients who do not tolerate aspirin. COX 1 = Ibuprofen, ketoroalac, Aleeve COX 2 = Celebrex, causes less GI bleeding