Term
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Definition
Level of stimulus needed to produce the perception of pain
A measure of the physiologic response of the nervous system |
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Definition
The amt of pain a person can endure without it interfering with normal function
Subjective response to pain, not a physiologic function
Varies by attitude, environment, culture, ethnicity |
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| Diabetic neuropathy is treated with |
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Definition
gabapentin (originally for a seizure disorder)
When patients w/o seizures are taking the med, it may be for neurologic pain |
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Definition
| Rubbing painful area with massage or liniment stimulates large sensory fibers and closes gate reducing pain |
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Definition
| When a family member does it instead of pt...run risk of overdosing pt...important that the pt do it. |
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Definition
| state of adaptation in which exposure to drug causes changes in drug receptors that result in reduced drug effects over time. |
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Term
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Definition
| They can be characterized by MOA: They are agonists - bind to an opiod pain receptor in the brain and cause an analgesic response; they can be agonist-antagonist - bind to a pain receptor and causes a weaker pain response. They can also be an antagonist binds to a pain receptor but does not reduce pain signals. |
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Term
| Opiod Analgesics - Indications |
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Definition
1) main use: to alleviate moderate to severe pain
2) often given with adjuvant analgesic drugs to assist primary drugs with pain relief
3) morphine: for post operative pain (acute and severe), metastatic cancer (chronic and severe), myocardial infarction
4) Opiods are also used for: cough center suppression, treatment of diarrhea, balanced anesthesia |
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Term
| Opiod Analgesics - Contraindications |
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Definition
| known drug allergy; severe asthma; (itching is common in morphine use-not an allergy---nausea is common in codeine use, not an allergy) use caution in respiratory insufficieny and morbid obesity and/or sleep apnea; myasthenia gravis; paralytic ileus; and pregnancy |
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Term
| Opiod Analgesics - Adverse Effects |
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Definition
Constipation due to GI tract motility; likely to be abused due to euphoria (mu) ; CNS depression (leads to respiratory
depression); nausea and vomiting; urinary retention; diaphoresis and flushing; pupil constriction (miosis); itching; addiction |
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Term
| Opiod Analgesics - toxicity and Management of overdose |
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Definition
`opiod withdrawal/opiod abstinence syndrome (anxiety, irritablility, chills, hot flashes, joint pain, lacrimation, rhinorrhea, diaphoresis; nausea, vomiting, abdominal cramps, diarrhea, confusion)
20 Physical dependence is seen when the opiod is abruptly discontinued or when an opiod antagonist is admistered
3) treat with naloxone or naltrexone - bind to opiate receptors and prevent a response.
4) pt should be given antagonist if they are in severe respiratory depression---even if withdrawal occurs |
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Term
| Opiod Analgesics - Interactions |
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Definition
| alcohol, antihistamines, barbituates, benzodiazepines, phenothiazine, other CNS depressents (additive respiratory depressent effects.), monoamine oxidase inhibitors (seizures/hypotension) |
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Term
| Opiod Analgesics - Lab Test Interactions |
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Definition
| can cause abnormal increase in the serum levels of amylase, alanine aminotransferase, alkaline phosphatase, bilirubin, lipase, creatinine kinase, and lactate dehydrogenase, decrease in urinary 17-ketosteroid levels and an increase in urinary alkaloid and glucose concentrations |
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Term
| Morphine Sulfate (Opiod Class) |
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Definition
1) derived naturally from opium poppy
2) Schedule II controlled substance - high abuse potential
3)available in oral, rectal, epidural, injectable dosge including PCA cartridges
Epidural dosage forms injected into the dura mater of the spinal cord
4) extended release include contin, Kadian and Avinza
5) has a potentially toxic metabolite known as morphine -6-glucuronide - accumulates more often in pts with renal impairment
6) for this reason hydromorphone, fentanyl, and oxymorphone may be safer choices for pts with renal insufficiency
7)hydromorphone is 8X more potent than morphine
8) epidural analgesics have potential for causing increased intracranial pressure, esp. with multiple injections |
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Term
| naloxone hydrochloride (Opiod antagonists) |
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Definition
1) pure opiod antagonist
2)works as a bloking drug for the opiod drugs
3) does NOT produce analgesia or respiratory depression
4) drug of choice for complete or partial reverssal of opiod induced respiratory depression
5) only injectable |
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Term
| Nonopiod Analagesics - Adverse effects |
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Definition
| Acetaminaphin does not have cardiac effects, bleeding, like NSAiDs; Acetametaphen is usually well tolerated. Possible adverse effects include rash, nausea, vomiting. Much less common, but mroe severe are blood disorders or dyscrasias (anemias) and nephrotoxicities and of most concern, hepatotoxicity |
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Term
Nonopiod Toxicity and Managing Overdose
Acetametaphen |
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Definition
1) lethal when overdosed
2) overdose causes hepatic necrosis, hepatotoxicity
3) long term ingestion of large doses also causes nephropathy
4) recommended antidote: acetylcysteine regimen |
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Term
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Definition
overdose causes damage to hepatic cells; toxicity is a serious problem; antidotes for overdose or toxicity are mucomyst (oral nebulizer) and Acetadote IV -
Acetaminophen does not have an anti-inflammatory profile |
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Definition
| one of the most serious is risk of GI bleeding caused by peptic ulcer or gastric ulcer. |
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Term
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Definition
| pain management, especially pain associated with inflammatory conditions such as arthritis b/c they have antiinflammatory properties as well as analgesic effects |
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Term
| A condition in which a pt develops withdrawal symptoms if drug is stopped abruptly or smaller doses given. |
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Definition
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Term
| A pattern of compulsive use of opiods or any other addictive substance - craving for substance and the need to use it for effects other than pain relief |
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Definition
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Term
| a chronic, neurobiologic disease whose development is influenced by genetic, psychosocial, and environmental factor |
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Definition
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Term
| overreliance by a person on a drug |
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Definition
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Definition
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Definition
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| pain from neuropathy (tingling) |
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Definition
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Term
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Definition
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Term
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Definition
| pain can be inhibited by stimuli other than pain because the gate is closed by other stimuli - example massage |
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Term
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Definition
post-operative pain (acute and severe)
metastatic cancer (chronic and severe)
myocardial infarction |
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Term
| Morphine contraindications |
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Definition
| head trauma or concussion |
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Term
| Morphine - one of the most serious adverse effects of opioids is... |
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Definition
| respiratory depression. Assess repiratory rate before administering. With overdose severe respiratory depression may occur. Worsens with alchohol. |
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Definition
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Term
| When a pt needs more dosage of an opioid to control the same pain level it is |
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Definition
| tolerance , not addiction |
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Term
| persistant or recurring pain that is often difficult to treat . Includes any pain lasting longer than 3-6 months. |
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Definition
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Term
| pain that originates from skeletal muscles , ligaments or joints |
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Definition
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Term
| herb commonly used for migraine headaches, menstrual problems, arthritis and fever |
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Definition
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Term
| smells and tastes like rotten eggs. better if put in soda or other liquid to disguise taste |
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Definition
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Term
| anticonvulsants used as adjuvants for treatment of |
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Definition
| neuropathic pain to enhance analgesic efficacy |
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