pain management

Question 1

pain

Answer 1

unpleasant physical and or emotional experience, associated with potential or actual tissue damage

Question 2

analgesia

Answer 2

reduce perception of pain

Question 3

nociception

Answer 3

experience of pain through the brains cerbral cortex

Question 4

noxious stimuli

Answer 4

a stimulus that causes pain

Question 5

noiciceptor

Answer 5

sensory receptor that responds to damaging or potentially damaging stimuli by sending electrical signals to the spinal cord and brain

Question 6

pre emptive analgesia

Answer 6

pain relief given that is appropriate to the anticipated pain before procedure is carried out to prevent pain establishing

Question 7

multimodal analgesia

Answer 7

the use of different classes of drugs in combination to desensitise multiple pain pathways

Question 8

wind up

Answer 8

perceived increase in pain intensity overtime when a stimulus is delivered repeatedly above a critical rate

Question 9

sensitisation

Answer 9

decrease in pain threshold and an increase in the magnitude of the response to noxious stimulation

Question 10

hyperalgesia

Answer 10

an increased sensitivity to pain

Question 11

transduction

Answer 11

translating noxious stimuli into nociceptive impulses

Question 12

transmission

Answer 12

movement of impulses via nerve endings to spinal cord and then to the brain

Question 13

modulation

Answer 13

process of amplification or dampening of nociceptive signals

Question 14

perception

Answer 14

subjective experience of pain and how it is experienced

Question 15

patient experience of pain

Answer 15

worsen experience during hospital stay, increase stress and fear

Question 16

client experience of pain

Answer 16

added cost, admin of pain meds

Question 17

recognition of pain - behavioural

Answer 17

restlessness
posture
gaurding
licking
lame
vocalisation
hiding
agression
decreased appetite

Question 18

recognition of pain - physiological

Answer 18

tachycardia
hypertension
pupillary dialation
hyper salivation
hyperthermia
elevation in parameters

Question 19

pain assesment

Answer 19

pain scoring
HR
vocilisation
movement
restlesness

Question 20

treating pain

Answer 20

pre emptive pain relief
multimodal
reassess pain every 2-4hrs

Question 21

opioid binding

Answer 21

bind to receptors in the CNS, GIT, urinary tract and smooth muscle

Question 22

opioid receptors

Answer 22

mu, delta, kappa

Question 23

full agonist

Answer 23

produce an effect when combined with a receptor

Question 24

antagonist

Answer 24

do not produce an effect when combined with a receptor

Question 25

partial agonist

Answer 25

produce some effect when combined with a receptor

Question 26

mixed agonist and antagonist

Answer 26

has effect on some receptors but not on others

Question 27

adverse effect of opioids

Answer 27

respiratory depression, reduced cough reflex, less responsive to co2 levels increased intra cranial pressure - vasodialation vomiting - stimulate chemoreceptor trigger zone bradycardia dogs- pin point pupils cats-dialated pupils histamine release

Question 28

opioids licenced for use

Answer 28

morphine, fentynl, methadone, butorphanol, buprenorphine, naloxone

Question 29

morphine

Answer 29

gold standard high affinaty to mu receptor class b controlled drug 4hr duration SQ, IM, IV

Question 30

fentaynl

Answer 30

full mu agonist potent analgesic with short action SQ, IM, IV, patches class b controlled drug

Question 31

methadone

Answer 31

full agonist lasts 3-4hrs no emetic effect SQ, IM, IV

Question 32

buprenorphine

Answer 32

partial mu agonist mild-moderate analgesia used in combinations slow onset lasts 6-8hrs ceiling effect class c controlled drug

Question 33

naloxone

Answer 33

reverse effects of opioids only used in overdose

Question 34

NSAIDS

Answer 34

anti inflamatory, anti pyretic, analgesic inhibitation of the COX enzyme acute and chronic pain management

Question 35

NSAIDS advantages

Answer 35

long duration non behaviour modifying lack of cardiopulmonary side effects

Question 36

COX 1

Answer 36

maintain renal and gastrointestinal mucosal blood flow aids platelet aggregation and blood clotting

Question 37

COX 2

Answer 37

produce prostaglandins responsible for inflammatory response

Question 38

adverse effects of NSAIDS

Answer 38

GI ulceration v + d kidney failure and acute renal failure synergy with corticosteroids

Question 39

NSAIDS contraindications

Answer 39

impared renal or hepatic function dehydration corticosteroids GI ulcers pregnant animals

Question 40

NSAIDS licensed for use

Answer 40

carprofen meloxicam firocoxib

Question 41

local blocks

Answer 41

dental nerve blocks limb nerve blocks infiltrative techniques topical intra articular epidural

Question 42

advantage of local regional analgesia

Answer 42

block transmission of pain reduce dose of other drugs minor sx in conscious animals addition to GA post op analgesia

Question 43

potential complications of local regional analgesia

Answer 43

systemic toxicity if IV nerve injury block wrong nerve

Question 44

local

Answer 44

lidocaine mepivicaine bupivicaine

Question 45

ocular drops

Answer 45

can damage cornea if repeated

Question 46

local transdermal patched

Answer 46

care with temp

Question 47

dental blocks

Answer 47

infraorbital mandibular maxillary

Question 48

limb nerve blocks

Answer 48

distal limb ring block brachial plexus nerve block sciatic nerve block

Question 49

intra articular blocks

Answer 49

injected into a joint to treat joint pain combined with steroid to reduce inflamation hip elbow stifle carpus tarsus

Question 50

epidural benefits

Answer 50

L6-L7 or L7-S1 combination of local and opioid muscle relaxation loss of hind limb motor function long duration cheap

Question 51

epidural adverse effects

Answer 51

hypotension urinary retention accidental spinal anaesthesia training required

Question 52

gabapentin

Answer 52

anti anxiety managment of neuropathic pain

Question 53

ketamine

Answer 53

dissociative anaesthetic analgesic properties altered behaviour in recovery