Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Med Surg > Pain > Flashcards

Pain Flashcards

1
Q

Acute Pain

A

Diminishes as healing occurs; responds well to analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chronic Pain

A

Lasts longer than three months, nerves may have become oversensitive and react to even a slight stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Neuropathic Pain

A

C/B damage to PNS or CNS; not well-controlled by opioids alone, needs adjuvent therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Characteristics of neuropathic pain

A

Numbing, shooting, stabbing, sharp, electric shock-like, burning. Example- diabetic nueropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Tolerance

A

Body adapts so exposure to a drug changes that result in a decrease in one or more of the drugs effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Physical Dependance

A

Symptoms c/b abrupt cessation, rapid dose reduction, decreased blood level, and/or administration of an antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Addiction

A

Primary, chronic, nuerobiologic disease w/genetic, psychosocial and environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Incident Pain

A

Transient increase in pain that is caused by a specific activity or event that precipitates pain. Examples- dressing changes, movement, position changes, and procedures such as catheterization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Breakthrough Pain

A

Transient, moderate to severe pain that occurs in patients whose baseline persistent pain is otherwise mild to moderate and fairly well controlled. 3-5 min, can last up to 30 min. Can happen several times a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

OLD CART

A

Onset, location, duration, characteristics, aggravating factors, relieving factors, treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Non-Opiods

A

Mild to moderate pain. NSAIDS decrease production of pain-sensitizing chemicals. Dont produce tolerance or dependence. Have an analgesic ceiling. Used with opioids to lower opioid dose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ASA (non-opioid)

A

Use limited due to side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tylenol (non-opioid)

A

Does not cause bleeding, but can be toxic to the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

NSAIDS

A

Can cause bleeding, renal toxicity, CHF in elderly, some interactions with anticoagulants, oral hypoglycemics, antihypertensives, diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do opioids work?

A

Modify the perception of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Opioids: Agonists

A

morphine, oxycodone, hydrocodone, codeine, methadone, hydromorphone.
Often combined with non-opioid analgesics limiting the total daily dose that can be given. Potent, have no analgesic ceiling, can be given through several routes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Opioids: Agonist-antagonist

A

Nubain, Talwin, Stadol
Produce less resp depression but cause more dysphoria and agitation, have an analgesic ceiling, can lead to withdrawal, not used much

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Avoid giving these drugs:

A

Darvon and Demerol- produce a toxic metabolite causing seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Opioids

A

Use for moderate to severe pain, use for breakthrough pain. Only need one b/c they are all similar pharmacologically. Can give by any route, oral route is preferred unless pain is severe or need dose titration. .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Opioids: Codeine

A

Weak opioid, requires an enzyme to break it down to work, not good for severe pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Opioids: Hydrocodone

A

Always combined with Tylenol or Ibuprofen, so does is limited

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Opioids: Oxycodone

A

Single or combined, long acting is OxyContin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Opioids: Morphine

A

Gold standard, roxanol, avinza and MS Contin are long-acting

24
Q

Opioids: Hydromorphone (Dilaudid)

A

8* more potent than morphine, only short acting

25
Q

Opioids: Fentanyl

A

72 hour patch (Duragesic), oral lozenge (Actiq), not for opioid-naive. Very short acting

26
Q

Opioids: Methadone

A

Works on 2 receptors, long half-life (23-36 hrs), sedation, bad for elderly

27
Q

Opioids: Tramadol (Ultram)

A

Atypical opioid, can cause seizures

28
Q

Opioids common side effects

A

Constipation, n/v, sedation, respiratory depression, itching (pruritus)

29
Q

Opioids less common side effects

A

Urinary retention (more common with epidural) dizziness, confusion, hallucinations, opioid-induced hyperalgesia (OIH)

30
Q

Adjuvants

A

Can be used alone or in combination

31
Q

Adjuvents: Corticosteroids

A

(prednisone, dexamethasone) Best for cancer pain, spinal cord compression, inflammatory join pain. Many side effects. Dont give with NSAIDS

32
Q

Adjuvents: Antidepressants

A

(TCA’s- Elavil, SNRI’s-Cymbalta) Increases serotonin & norepinephrine, promotes sleep, dont give if hx of seizures or cardiac disease, bad for older adults (long half life), many side effects, SNRI’s have less side effecs, but cost more

33
Q

Adjuvents: Antiseizure drugs

A

(Lamictal, Neurontin, Lyrica) Affect peripheral nerves and CNS

34
Q

Adjuvents: GABA receptor agonists

A

(Baclofen) inhibits pain trandmission, used for muscle spasms, best used intrathecally

35
Q

Adjuvents: Alpha Adrenergic Agonists

A

(clonidine, zanaflex) used for chronic headaches, nueropathic pain

36
Q

Adjuvents: Local analgesics

A

Interrupts transmission of pain signals to the brain, works for types of nueropathic pain

37
Q

Med Administration: Breakthrough or Incident Pain

A

Use fast acting meds

38
Q

Med Administration: Titration

A

Adjusting does based on adequacy of analgesic effect verse side effects

39
Q

Med Administration: Equinanalgesic dosing

A

Carefully monitor and adjust for each individual patient

40
Q

Administration Routs: Oral

A

Route of choice if GI system is good. Opioids require a larger dose than IV or Im due to first pass effect. Slower onset, peak in 1-2 hours, dont crush, break, chew sustained-release drugs

41
Q

Administration Routes: Sublingual/buccal

A

Bypasses the first pass effect, doesnt always work well,Fentanyl can be given as a “lollipop”

42
Q

Administrarion Routes: Intranasal

A

Stadol, Sumatriptan; used for headache and migraines

43
Q

Administration Routes: Rectal

A

Often overlooked, Good if pt has n/v, NPO, at home. Lasts 4-6 hours, can’t use if bleeding risk

44
Q

Administration Routes: Transdermal

A

Fentanyl Patch. Slow to reach full effect when first applied. Can cause death from overdose (s/s- slow RR, confusion, dizziness) Can absorb med too quickly if febrile

45
Q

Administration Routes: Creams/Lotions

A

Trolamine salicylate for joint/muscle pain; capsaicin; EMLA. Little systemic absorption, can cause skin reactions

46
Q

Administration Routes: Parenteral (SC, IM, IV)

A

IM is not recomended due to pain, unreliable absorption, abscesses with frequent use
SC is rarely used due to slow response, but can be used if no IV access
IV is best for immediate analgesia and rapid titratin (fastest onset but shorter duration, peaks in 5-15 min, not good for constant pain)

47
Q

Administration Routes: Intraspinal

A

Epidural or Intrathecal. Intermittent bolus or intrathecal. Tip of catheter placed as close to nerve as possible. Highly potent and requires much smaller doses.

48
Q

Administration Routes: Intraspinal Cx and s/e

A

S/E- itching, nausea, urinary retention.

Cx- Catheter displacement, accidental infusion of nuerotoxic agents, infection

49
Q

Adminstration Routes: Patient Controlled Analgesia

A

IV delivery system or epidural catheter. PT decides when dose is needed, can have continuous basal rate, be careful w/opioid naive patients, monitor sedation level and resp rate, important to do good pt teaching.
*Give before pain is severe, assure them they can’t “overdose,” start oral drugs as PCA is being tapered, only the pt can push the button

50
Q

Nerve Block

A

regional analgesia, used during and after surgery, sometimes used for chronic pain syndromes

51
Q

Nueroblative Techniques

A

Used for severe pain unresponsive to other tx, destroys the nerves by surgical resection or thermocoagulation

52
Q

Nueroaugmentation

A

Electrical stimulation of the brain and spinal cord, used for chronic back pain from nerve damage, also CRPS, spinal cord injury

53
Q

Non-Drug Therapies

A

Massage, exercise, TENS (primarily for acute pain), acupuncture, heat, cold, distraction, hypnosis, relaxation strategies

54
Q

Gerontologic Considerations W/drug therapy

A

High prevalence of cognitive, sensory-perceptual, and motor problems making it harder to assess. Metabolize drugs more slowly. NSAIDS cause serious GI bleeding in elderly. Cognitive impairment/ataxia can be worsened w/analgesics

55
Q

Substance Abusers

A

Still use opioids but not opioid agonist-anatagonists. Avoid psychoactive drugs. Many need higher doses or increased frequency of administration. Need a multidisciplinary approach.

Med Surg (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions