Pain Management

Question 1

What is the definition of pain?

Answer 1

An unpleasant sensory and emotional experience associated with actual or potential tissue damage

Question 2

Why is pain subjective?

Answer 2

Because it’s difficult to see, quantify, and varies between individuals

Question 3

What are common causes of pain?

Answer 3

Injury
inflammation
cancer
unknown events

Question 4

What are the types of pain mechanisms?

Answer 4

Neural
chemical
inflammatory mechanisms

Question 5

What are the main categories of pain medication?

Answer 5

Opioid and non-opioid analgesics

Question 6

What is tolerance?

Answer 6

A need to increase dosage to achieve the same effect over time

Question 7

What causes opioid tolerance?

Answer 7

Decreased receptor sensitivity and number, discrupted receptor G protein

Question 8

What is opioid-induced hyperalgesia?

Answer 8

Increased pain sensitivity due to chronic opioid use

Question 9

How should clinicians respond to unexpected pain increase in opioid users?

Answer 9

Document pain reports and notify the physician

Question 10

What is physical dependence?

Answer 10

A condition where withdrawal symptoms occur when the drug is stopped

Question 11

What are the symptoms of opioid withdrawal?

Answer 11

Cravings\substance- seeking behavior
symptoms starting 5-10 hours after last dose

Question 12

What are strong opioid agonists?

Answer 12

Drugs like morphine used for severe pain

Question 13

What are mild-to-moderate opioid agonists?

Answer 13

Drugs like codeine used for moderate pain

Question 14

What are mixed agonist-antagonist opioids?

Answer 14

Drugs that activate some receptors and block others

Question 15

What are opioid antagonists?

Answer 15

Drugs like naloxone that block opioid receptors

Question 16

How do opioids work at the spinal level?

Answer 16

They inhibit pain signal transmission to the brain

Question 17

How do opioids work at the brain level?

Answer 17

They activate descending pain pathways to inhibit spinal synapses

Question 18

What is the peripheral effect of opioids?

Answer 18

Reduce excitability of sensory neurons outside CNS

Question 19

When are opioids commonly used?

Answer 19

Post-surgery
trauma
MI
cancer- related chronic pain

Question 20

What is Patient Controlled Analgesia (PCA)?

Answer 20

A system allowing patients to self-administer controlled doses of pain medication

Question 21

What are common opioid side effects?

Answer 21

Nausea
constipation
drowsiness
respiratory depression

Question 22

What are serious adverse effects of opioids?

Answer 22

Cognitive impairments
mood changes
OH
falls
death

Question 23

Why is therapy timing important with opioids?

Answer 23

Pain relief can improve participation if therapy is scheduled at peak drug effect

Question 24

What is the onset time for oral hydromorphone?

Answer 24

30–90 minutes

Question 25

What is the onset time for IV morphine?

Answer 25

20 minutes

Question 26

What is the onset time for oral codeine?

Answer 26

60–120 minutes

Question 27

What is the onset time for oral hydrocodone?

Answer 27

30–60 minutes

Question 28

What is the onset time for oral oxycodone?

Answer 28

60–90 minutes

Question 29

What is the main purpose of NSAIDs?

Answer 29

Decrease inflammation mild to moderate pain fever clotting

Question 30

What is the mechanism of action of NSAIDs?

Answer 30

Inhibition of prostaglandin and thromboxane via COX enzymes

Question 31

What is the downside of non-selective NSAIDs?

Answer 31

GI irritation and kidney dysfunction

Question 32

What is a benefit of selective COX-2 inhibitors?

Answer 32

Fewer GI side effects

Question 33

What are examples of selective COX-2 inhibitors?

Answer 33

Celecoxib (Celebrex)

Question 34

What is acetaminophen used for?

Answer 34

Mild-to-moderate pain and fever

Question 35

What is a limitation of acetaminophen?

Answer 35

Poor anti-inflammatory and anticoagulant effects

Question 36

What is a side effect of acetaminophen overdose?

Answer 36

Liver damage

Question 37

What are general therapy considerations for anesthesia?

Answer 37

Schedule rehab after anesthesia effects subside

Question 38

What are the stages of general anesthesia?

Answer 38

Progressive CNS depression from drowsiness to unconsciousness

Question 39

What are common side effects of general anesthesia?

Answer 39

Delirium muscle weakness bronchial secretions long term cognitive issues

Question 40

What are common general anesthesia drugs?

Answer 40

Ketamine nitrous oxide benzodiazepines propofol opiods

Question 41

What is the purpose of neuromuscular blockers?

Answer 41

Paralyze muscles during surgery

Question 42

What are side effects of neuromuscular blockers?

Answer 42

Cardiovascular issues hyperkalemia histamine response prolonged weakness

Question 43

What is local anesthesia?

Answer 43

Loss of sensation in a targeted area

Question 44

What are common uses for local anesthesia?

Answer 44

Minor surgeries c-sections chronic pain relief

Question 45

What are nonsurgical uses for local anesthesia?

Answer 45

Bursitis tendinitis cancer treatments

Question 46

What are physical therapy delivery methods for local anesthesia?

Answer 46

Iontophoresis and phonophoresis

Question 47

What suffix is common in local anesthetics?

Answer 47

-caine

Question 48

Why is patient monitoring important in pain management?

Answer 48

To track effectiveness side effects safety

Question 49

When should a physician be contacted in pain management?

Answer 49

When pain meds are ineffective or adverse reactions are suspected