Pain Flashcards
(22 cards)
describe the presentation of nociceptive pain.
sharp
dull
well localised
describe the presentation of neuropathic pain.
burning
tingling
shooting
pins and needles
what is the difference between neuropathic and nociceptive pain?
nociceptive;
- protective function
- obvious tissue damage
- physiological/ inflammation
neuropathic;
- no protective function
- no obvious tissue injury
- nervous system damage/ abnormality
what approach is used for determining pain management for a patient?
RAT criteria
Recognise - do they look in pain, ask family/friends if they are in pain
Assess - severity, type, other factors i.e. other illnesses, psychological
Treat - pharmacological or non-pharmacological
what is involvement in a pain assessment?
visual analogue score verbal rating score numerical rating score smiling faces abbey pain scale (people with confusion) functional pain
what is the gate theory of pain?
nociceptive pain signals can be inhibited by distractor signals from mechanoreceptors i.e. rubbing (a-alpha and a-beta fibres )
they give of inhibitory interneurone which inhibits the firing of A-delta and C fibres
what are the non-drug treatments for pain?
rest, ice, compression, elevation
TENS, surgery, acupuncture, massage
psychological
what is used to determine what drugs to give for pain management?
WHO pain ladder
what are the treatments given for mild, moderate and severe pain on the WHO ladder?
mild: paracetamol (+/- NSAID)
moderate: paracetamol (+/- NSAID) + codeine or alternative
severe: paracetamol (+/- NSAID) + morphine
is the WHO ladder used for all types of pain?
only nociceptive pain not used for neuropathic pain
they have different treatments
what are the treatment options for neuropathic pain?
non-pharmacological
pharmacological:
- amitriptyline
- gabapentin
- duloxetine
what treatments act at the periphery?
NSAIDS
rest, ice, compression, elevation
local anaesthetics
what treatments act on the spinal cord?
acupuncture, massage, TENS
opioids, ketamine
local anaesthetics
what treatments act on the brain?
psychological
opioids, paracetamol, amitriptyline, clonidine
what is the main side effect of paracetamol?
liver damage
what are the main side effects of NSAIDS?
GI and renal damage
bronchospasm in severe asthmatics
what is the main side effect from codeine?
constipation
what is the main side effect from tramadol?
nausea and vomiting
what are the main side effects of morphine?
constipation
respiratory depression in high doses
addiction misunderstandings
what is the main side effect from amitriptyline?
anti-cholinergic side effects
i.e. glaucoma, urinary retention
what drug is effective for chronic cancer pain?
morphine
what type/severity of pain is codeine not use in?
chronic pain
