Weird E-lecture stuff Flashcards
(15 cards)
Symptom Assessment and Management
Sensory nerves carrying pain transmission
Adelta + C fibres
Symptom Assessment and Management
Area of brain capable of modulating pain sensation.
Thalamus
Symptom Assessment and Management
Area of brain responsible for pain localisation and perception.
Cortex
Symptom Assessment and Management
inhibitory pain mechanisms in descending pathway at a) locus coeruleus
b) Raphe nucleus
a) Nor AD
b) 5HT serotonergic
Serotonin can be stimulatory
Symptom Assessment and Management
Chronic pain pathophysiology
Thought to be due to refractory abherrent activity of the ascending/descending pain pathways. Leads to increased excitability
Symptom Assessment and Management
Methods of pain assessment
VAS Body map (PT draws) PQRST McGill Pain assessment Brief Pain Inventory Faces (non verbal) Behavioural observational pain rating scale
Symptom Assessment and Management
What does PQRST stand for?
Precipitation Quality Relief Radiation Scale Time
Symptom Assessment and Management
What is the WHO ladder?
Non opioid
Opioid for mild/mod
Opioid for mod/sev
Symptom Assessment and Management
PAIN RED FLAGS
Daily doubling of doses Pain non-repsonsive to step 3 opioids Complex pain - cancer/neuropathy/depression Drug seeking behaviours Escalating over yrs
Symptom Assessment and Management
1st line Anti-emetics
Metoclopramide/Domperidone
(dop ag)
Cyclyzine (achM / hist antagonist)
Symptom Assessment and Management
2nd line antiemetics
Haloperidol (dope/Ach/Gaba)
Levomepromazine (5HT2/dop/ach/gaba)
Ondansetron (5HT3)
Symptom Assessment and Management
Faeces softener/stimulant
Lactulose / senna
Movicol / senna
Cancer Pain
Causes of Cancer pain?
Invasion
Rx related
Secondary - infection/ICP/inc calcium
Comorbid - depression / anxiety etc
Cancer Pain
Opioid analgesia inhibits ascending or descending?
Inhibits ascending
Activates descending inhibition
Cancer Pain
Antidepressants can enhance morphine-induced analgesia T/F?
T
