Chapter 49: Drug Therapy with Opioids

Question 1

Breakthrough pain

Answer 1

episodic burst of intense pain that “breaks through” the pain control of the medication

Question 2

ceiling effect

Answer 2

a phenomenon of certain drugs that limits the ability to produce a further effect above a particular dosage level

Question 3

Endogenous analgesia system

Answer 3

nerve signals that relieve pain by suppressing the transmission of pain signals from peripheral nerves; can be activated by nerve signals entering the brain or by morphine-like drugs

Question 4

Endorphins

Answer 4

morphine-like neuropeptides (hormones) that interact with neuroreceptors to inhibit the transmission of pain signals while also producing a sense of euphoria

Question 5

Enkephalins

Answer 5

morphine-like neuropeptides (hormones) that interrupt the transmission of pain signals at the spinal cord level by modulating pain perception, mood, behavior and neuroendocrine regulation

Question 6

Nociceptors

Answer 6

nerve endings that selectively respond to painful stimuli and send pain signals to the brain and spinal cord

Question 7

Opioid-naive

Answer 7

pts who do not meet opioid-tolerant criteria and have not had at least 60mg of morphine or an equianalgesic dose of another opioid for a week or longer

Question 8

Opioid-tolerant

Answer 8

patient has been taking at least 60mg of morphine or an equivalent dose of another opioid for a week or longer

Question 9

Patient controlled analgesia

Answer 9

any method used by patients to administer their own pain medication, typically used to indicate administration through a controlled intravenous pump

Question 10

Acute pain

Answer 10

fast pain aroused by mechanical and thermal stimuli. may result from trauma, spasm, disease processes, or treatments that damage body tissues. The intensity of pain is usually proportional to the amount of tissue damage

Question 11

Chronic (noncancer) pain

Answer 11

lasts 3 months or longer. demands attention less urgently and may not be characterized by visible signs. Often accompanied by emotional stress, increased irritability, loss of libido, distressed sleep, etc. burning, aching or throbbing pain

Question 12

Cancer pain

Answer 12

both acute and chronic pain characteristics. May be constant or intermittent. Chronic pain is often caused as tumors spread into pain-sensitive tissues. progresses as the disease advances and can be severe/debilitating. Acute pain is associated with diagnostic procedures or treatments

Question 13

Somatic Pain

Answer 13

results from stimulation of nociceptors in the skin, bone, muscle, and soft tissue. It is usually well localized and described as sharp, burning, throbbing, or cramping.

Question 14

Visceral Pain

Answer 14

is diffused and not well localized. results when nociceptors are stimulated in abdominal or thoracic organs and their surrounding tissues. Pain may be refferred. severe visceral pain stimulates the parasympathetic nervous system and produces decreased blood pressure and pulse, nausea and vomiting, weakness, syncope, and loss of consciousness

Question 15

Neuropathic Pain

Answer 15

caused by lesions of physiologic changes that injure peripheral pain receptors, nerves, or CNS. pain may arise spontaneously or from normal nonpainful stimuli such as light touch.

Question 16

SOCRATES

Answer 16

Site, Onset, Character, Radiation, Associations with other symptoms, Time course, Exacerbating/relieving factors, Severity