Brainscape's Knowledge GenomeTM

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


See full index

Nurs 216 > Pain & Inflammation > Flashcards

Pain & Inflammation Flashcards

1
Q

1st step

A

Assess pain- scale of 0-10

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

<4/10

A

non-opioid meds (NSAIDs, Tylenol)

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

4-6/10

A

opioids, PO route (codeine, morphine)

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

> 6/10

A

higher potent opioids, IV route

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

Pain treatment: Analgesia

A

stops pain signal transmission @ peripheral and CNS

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

Peripheral level

A

non-opioid, NSAIDs- treatment for low-moderate pain, high efficacy for inflammation

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

CNS level

A

Acetaminophen, opioids (narcotics)

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

Acetaminophen

A

tylenol - centrally acting analgesic (not NSAID)

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

Acetaminophen Absorption

A

PO good bioavailability, peak plasma concentration after 30-60 mins

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

Acetaminophen Distribution

A

well distributed, low PPB (20%)

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

Acetaminophen Metabolism

A 
active metabolite through hepatic metabolism 
toxic metabolite (N-acetyl benzo) is phase 2 metabolized by glutathione conjugation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acetaminophen Excretion

A

renal excretion, 2-3 hrs

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

Opioids (morphine-like) as analgesic

A

are agonists, lock-key fit into receptors (mu, kappa, delta), fits into receptor decreasing release of substance p = less action potenial=less pain

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

Acetaminophen metabolite metabolism

A

phase 1 -> hydrolyze into N-acetyl-p-benzo. (hepatotoxic) -> Phase 2-> glutathione enzyme conjugation produces inactive metabolite

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

Mu receptor: effect, agonist, and antagonist

A

effect- analgesia, euphoria, low abuse potential, bradycardia, hypothermia
agonist- endorphins, morphine, synthetic opioids
antagonist- naloxone, naltrexone, nalmefene

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

Kappa receptor: effect, agonist, and antagonist

A

effect- analgesia, sedation, low abuse potential, diuresis
agonists- dynorphins
antagonist- naloxone, naltrexone, nalmefene

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

Delta receptor: effect, agonist, and antagonist

A

effect- analgesia, depression of ventilation, physical dependence, constipation
agonists- enkephalins
antagonist- naloxone, naltrexone, nalmefene

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

opioids meds

A

used for moderate to severe pain, also in general anesthesia

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

High efficacy opioids

A

mu-receptor agonists ex. fentanyl, meperidine, morphine, methadone, tramadol

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

Mod. efficacy opioids

A

hydrocodone, combination drugs

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

Low efficacy opioids

A

codeine, Tylenol 1-4

22
Q

Combination drugs

A

synergy effect ex. percocet (oxycodone+acetaminophen), percodan (oxycodone+ ASA), vicodin (hydrocodone + acetaminophen), tramacet (tramadol+acetaminophen), T 1-4 (oxycodone+acetaminophen+caffeine)

23
Q

GI pain

A

med: dicyclomine (muscarinic antagonist, GI smooth muscle relaxant)

24
Q

MI pain

A

med: morphine (opioid, decreased vasoconstriction=low bp & co)

25
Q

opioid side effects

A

CNS depression (sedation, low rr, hr, bp & loc, pupillary constriction), nausea & vomitting, pruritus (itchy), constipation, urinary retention, & euphoria

26
Q

opioid antagonists

A

no efficacy, block opioid receptors from binding. clinical use: resp. depression, sedation and hypotension
ex. naloxone, naltrexone, nalmefene

27
Q

Tx for overdose

A

Naloxone: 2-4 min onset, 45 min duration, half-life of 60-90 min

28
Q

Tx for addiction

A

Naltrexone

29
Q

NSAIDs

A

prostaglandin target, useful if pain is associated w inflammation caused by cellular injury

30
Q

prostaglandins

A

lipids made at sites of tissue damage or infection by COX enzyme

31
Q

COX 1

A

found in all tissues, protects gastric mucosa, supports kidney function, & promotes platlet aggregation
produces baseline prostaglandin

32
Q

COX 2

A

present at site of tissue injury, mediates inflammation, sensitizes pain receptors, mediates fever in brain
produces prostaglandin at site of injury

33
Q

selective COX 2 inhibitor

A

only inhibits COX 2 not COX 1. passes BBB to treat fever and doesnt affect gastric mucosa or kidney function
ex. celecoxib

34
Q

Non-selective COX inhibitors (NSAIDs)

A

inhibits both COX 1 & 2. increased risk of gastric bleeding and reduced kidney function
ex. Acetylsalicylic acid, ibuprofen, indomethacin

35
Q

Acetylsalicylic acid & examples of uses

A

aspirin (enteric coated)

ex. low dose antithrombotic (cardiac treatment), low-moderate joint pain

36
Q

Ibuprofen & examples of uses

A

advil

ex. headache (first used in migraine protocol), soft tissue swelling (tx for sprains)

37
Q

Indomethacin & examples of uses

A

ibuprofen-like

ex. moderate-severe joint pain (arthritis, gout)

38
Q

NSAID precautions and interventions

A

monitor LIVER FUNCTION, KIDNEY FUNCTION, for symptoms of salicylism (toxicity), monitor complete blood count

39
Q

NSAID side effects

A

indigestion, gastric ulcers & bleeding, decreased kidney function, drowsiness

40
Q

ASA

A

works in acidic conditions. Not used in children can cause Reye’s syndrome=liver and brain problems

41
Q

Natural glucocorticoids

A

lipophilic endogenous hormone from adrenal cortex. nuclear receptor binding since it enters the cell

42
Q

Natural glucocorticoid metabolic effects

A

for survival during fasting, stimulates gluconeogenesis (converting non carb. substrates into glucose), stimulates protein degradation, facilitates lipolysis

43
Q

Glucocorticoids as drug

A

more potent than endogenous. high efficacy for anti inflammation, PO/IV

44
Q

Glucocorticoids as drug MOA

A

suppress histamine release, prostaglandin synthesis inhibition (COX-2), suppress phagocytes/lymphocytes

45
Q

short acting glucocorticoids (-one)

A

hydrocortisone, cortisone, prednisone, prednisolone, methylprednisolone

46
Q

long acting glucocorticoids (-one)

A

dexamethasone

47
Q

glucocorticoids ADME

A

lipophilic -> hydrophilic via metabolism = easily excreted
highly PPB
Prodrug: Prednisone-> Prednisolone

48
Q

Glucocorticoid uses

A
  • Inflammation (IBD, Lupus) ex. dexamethasone (PO, low dose, daily)
  • Joint Pain ex. cortisone injections
  • Anaphylaxis, stabilization of patient post anaphylactic shock ex. prednisolone IV, follow by PO prednisone x 3 days
49
Q

intranasal glucocorticoids

A

allergic rhinitis, few side effects since low systemic distribution
ex. budenoside, fluticasone, mometasone

50
Q

inhaled glucocorticoids

A

for asthma ex. pulmicort (budenoside)

Nurs 216 (6 decks)

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