general pain management principles

Question 1

What is the immediate goal of pain management?

Answer 1

To reduce pain to a level that allows the patient to perform reasonable ADLs.

Question 2

Who should be considered the expert on their pain?

Answer 2

The patient.

Question 3

What is a patient right in terms of pain?

Answer 3

Pain management.

Question 4

What does “analgesia” mean?

Answer 4

Loss of sensibility to pain.

Question 5

What does “anesthesia” mean?

Answer 5

Loss of pain and all other sensation.

Question 6

Should nonpharmacologic interventions be used for pain?

Answer 6

Yes, they should be encouraged.

Question 7

What approach is considered optimal for pain management?

Answer 7

A combination of therapies.

Question 8

How should pain medication dosing be handled?

Answer 8

It should be individualized and adjusted.

Question 9

What should be done about adverse effects from pain medication?

Answer 9

They should be anticipated and prevented whenever possible.

Question 10

When should around-the-clock dosing be used?

Answer 10

For moderate to severe pain.

Question 11

Is it easier to maintain a pain-free state or to eliminate existing, escalating pain?

Answer 11

It’s easier to maintain a pain-free level.

Question 12

How is acute pain defined?

Answer 12

Pain with abrupt onset but brief duration.

Question 13

How is chronic pain defined?

Answer 13

Pain lasting longer than 6 months.

Question 14

Do all patients appear to be in pain?

Answer 14

No, not all patients show visible signs.

Question 15

Can patients sleep even if they are in pain?

Answer 15

Yes, they can.

Question 16

Will most patients become addicted to their medications?

Answer 16

No, most will not.

Question 17

Do patients over-report pain because they are addicted?

Answer 17

No, they do not.

Question 18

What can unrelieved pain cause?

Answer 18

Anxiety and fatigue.

Question 19

What are nonpharmacological therapies used for?

Answer 19

To reduce and augment analgesic drugs and obtain adequate pain relief.

Question 20

What is a benefit of using nonpharmacological methods?

Answer 20

They allow for lower doses of drugs.

Question 21

What is the maximum daily dose of acetaminophen?

Answer 21

4000 mg.

Question 22

Name some nonpharmacologic pain relief methods.

Answer 22

Acupressure, acupuncture, cold or heat application, biofeedback therapy, distraction, art/music therapy, laughter.

Question 23

What are examples of nonopioids?

Answer 23

NSAIDs, centrally acting agents, acetaminophen.

Question 24

What are nonopioids used for?

Answer 24

Mild to moderate pain.

Question 25

Give an example of a combination of nonopioids equal to hydrocodone.

Answer 25

500 mg Tylenol + 200 mg ibuprofen.

Question 26

What are opioids used to treat?

Answer 26

Severe pain.

Question 27

What are adjuvant analgesics used to treat?

Answer 27

Chronic neuropathic pain.

Question 28

What are combination drugs?

Answer 28

Drugs that include both opioid and nonopioid components.

Question 29

What forms are combination drugs available in?

Answer 29

Fixed-dose tablets or capsules.

Question 30

Why is there a dose ceiling with combination drugs?

Answer 30

Because of toxicities of the nonopioid component (e.g., acetaminophen liver toxicity).

Question 31

Name some examples of combination drugs.

Answer 31

Endocet, Norco, Percocet, Percodan, Lortab 5, Vicodin HP.

Question 32

What is patient-controlled analgesia (PCA)?

Answer 32

An infusion pump that allows patients to self-administer medication.

Question 33

What is a benefit of PCA?

Answer 33

It may reduce anxiety about waiting for drug administration.

Question 34

What drug is usually used in PCA?

Answer 34

Morphine.

Question 35

What is a requirement for using PCA?

Answer 35

The patient must be conscious and able to understand the pump.