Week 11-Drugs to treat pain: Narcotics and Narcotic Agonists Flashcards
(54 cards)
What is pain?
Sensory and emotional experience associated with actual or potential tissue damage
What is the gate-control theory of pain?
- transmission of these impulses are modulated or adjusted
- interneurons can act as “gates”
- several factors can activate the descending inhibitory nerves from the upper central nervous system including culture, learned experience, individual tolerance, placebo effect
What is acute pain?
sudden onset that usually subsides after treatment
What is nociceptive caused by?
direct stimulus to pain receptors (somatic and visceral pain)
What is chronic pain?
- persistent or recurrent pain
- 6 weeks or longer
- can be intermittent, occur in a pattern or persist (lasting more than 12h a day)
What is somatic pain?
nociceptive pain that includes skin/superficial/bone/connective tissue
What is visceral pain?
nociceptive pain that is of the internal organs
What are the 2 kinds of nociceptive pain?
somatic and visceral
What is neuropathic pain?
- pain from abnormal or damaged nerves
- central of peripheral
Why is pain management important?
helps you heal faster
What is most often the cause of visceral pain?
obstructions (often from tumours)
What are analgesics?
medication that relieve pains
- narcotic (moderate to severe pain)
- non-narcotic (mild to moderate pain)
What are ‘pain killers’?
analgesics
What are the general characteristics of narcotic/opioid analgesics?
- relieves moderate to severe pain
- react with opioid receptors throughout the body to cause analgesia, sedation or euphoria
Why did the narcotic safety and awareness act (2010) come about?
between 1991 and 2009 the number of prescriptions in Ontario for oxtcodone drugs rose by 900%
What does the narcotic safety and awareness act (2010) say?
- patients need to SHOW ID in order to be prescribed a narcotic or controlled substance medication
- implemented a MONITORING system to tract dispension of prescription narcotics
What are some of the common drugs being monitored?
- T3’s (acetaminophen compound with codeine and caffeine)
- Percocet (oxycodone HCl & acetaminophen)
- Oxycotin (Oxycodone HCl)
- dilaudid (hydromorphone hcl)
- statex, ms cotin (mophine sulfate)
-codeine, codeine contin
( codeine sulfate) - demerol (meperidine HCl)
What are the indications for narcotic use?
- prevent or relieve ACUTE or CHRONIC (moderate to severe pain)
- chronic pain ONLY when other measures and milder drugs are ineffective
- for SURGERY
- invasive DIAGNOSTIC procedures
Are opioids only used on their own or as an adjunct?
as an adjunct with pain relievers
- NSAIDS
- Antidepressants
- Anticonvulsants
- Corticosteroids
Why would antidepressants be used for pain relief and when would it be indicated??
neuropathic pain responds to antidepressants
Why would steroids be used for pain?
antiinflammatory action helps with pain
What are some opioid agonists?
Codeine
Hydromorphone (Dilaudid)
Meperidine (Demerol)
Morphine
What dose the RNAO BPG on pain say about pharmacological interventions?
- multimodal analgesic approach
- changing of opioids (dose or route) when necessary
- Monitoring for safety and efficacy
- Prevention, assessment and management of adverse effects
- Prevention, assessment and management of opioid risk
Based on the RNAO BPG on Pain, how can the nurse ensure that the prescribed analgesic is appropriate for the client?
- Use most efficacious (able to effect something)
- Multimodal analgesic approach (combo of opioid and non-opioid)
- Effective dosing schedule
- Recognize potential contraindications
- Dose titration (adjusting dose based on different people)
- Anticipate and manage adverse effects
