Chpt. 7 - Key Points Flashcards Preview

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Flashcards in Chpt. 7 - Key Points Deck (26):
1

How can a vet tech contribute significantly to the comfort and welfare of PTs?

Through an understanding of:
- pain physiology
- pain-associated behaviors
- pain assessment tools
- analgesic drug pharmacology
- communication skills

2

What is an essential part of every PT evaluation, regardless of presenting complaint?

Pain assessment!

3

Define pain

- a complex, individual experience
- an aversive sensory and emotional experience eliciting protective motor actions
- resulting in learned avoidance
- may modify species-specific behavior traits, incl. social behavior

4

Untreated pain can negatively affect a PT's what?

- Behavior
- Physiology
- Metabolism
- Immune system

5

Untreated pain and its negative side effects may cause?

- Poor performance
- Weight loss
- Delayed wound healing
- Increased susceptibility to infection
- PT suffering

6

Define physiologic pain

- occurs in response to a noxious stimulus where there is no or minimal tissue injury
- is a protective mechanism

7

Define pathologic pain

- occurs after a noxious stimulus that results in tissue injury
- can be classified based on origin, duration, and severity

8

Name the four components of the pain pathway

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

9

What is peripheral hypersensitivity or primary hyperalgesia caused by?

Presence of inflammation

10

What is central hypersensitivity or secondary hyperalgesia ("windup") caused by?

Changes to neurons in the spinal cord

11

Define preemptive analgesia

The practice of administering analgesics before Sx to decrease analgesic requirements and minimize CNS sensitization.

12

Define multimodal analgesia

The practice of administering several analgesic drugs that work via different receptor mechanisms.

13

What are pain assessment tools used for?

- to assess pain and response to analgesic therapy

14

Name the most effective drugs for treating acute pain.

Opioid analgesics such as:
- Morphine
- Oxymorphone
- Hydromorphone
- Methadone
- Fentanyl
(all of these are opioid receptor agonists)

15

What are the potential side effects of the mu-agonist opioids?

- Sedation
- Respiratory depression
- Vomition
- Defecation
- Gastrointestinal ileus
- Pruritus
- Excitement
- Hyperthermia
- Dysphoria

16

Buprenorphine

- partial agonist opioid
- long duration of action
- may not provide sufficient analgesia for severe acute pain
- provides good analgesia in rodents

17

Butorphanol

- agonist-antagonist opioid
- short duration of action
- not as effective in treating severe pain
- fewer side effects
- used extensively in large animals

18

How do NSAIDs work and how are they used.

- decrease inflammation by inhibiting prostaglandin synthesis
- commonly used to provide analgesia postoperatively
- commonly used in PTs with less severe or inflammatory pain

19

Side effects of NSAIDs

- liver toxicity
- renal toxicity
- increased bleeding times
- gastrointestinal ulceration

20

How do local anesthetics work and how are they administered.

- provide analgesia via their sodium channel blocking activity
- can be administered locally, epidurally, or, in the case of lidocaine, as a CRI

21

Alpha2-adrenoceptor agonists

- effective analgesics
- have side effects in small animals and ruminants
- commonly used in horses

22

What does ketamine antagonize?

NMDA receptors in the spinal cord, preventing central sensitization.

23

Corticosteroids

- potent antiinflammatory activity
- same mechanism as NSAIDs
- do not use concurrently w/NSAIDs

24

Tramadol

- nonopiate drug
- activity at mu receptor
- given orally
- commonly as part of an analgesic plan for PT at home

25

What is an important part of ensuring that a hospitalized PT is comfortable?

Providing appropriate nursing care when a hospitalized PT's pain is being treated.

26

Nonpharmacologic therapies

e.g. acupuncture
- may effectively treat pain by stimulating the release of endorphins