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CLPH 471
Pain Management
16
Pharmacology
Graduate
04/22/2012

Additional Pharmacology Flashcards

 


 

Cards

Term

 

Pain Definition

Definition

 

An unpleasant sensory and emotional experience associated with actual or potential tissue damage.  A sensation in which a person experiences discomfort, distress, or suffering due to provocation of sensory nerves.

SUBJECTIVE MEASURE

Term

 

Acute Pain

Definition

 

follows injury to the body and generally disapperas when the bodily injury heals.  It has well defined temporal onset and is often associated with physical signs.  Described as mild, moderate, or severe.  It usually responds to drug therapy.

Term

 

Chronic Pain

Definition

 

Persists beyond the expecting healing time (pain after 6 months-muscle healing usually takes place over 2-3 months) and often cannt be ascribed to the effects of a specific injury.  It may or may not have a well defined onset and frequently does not respond to typical analgesic therapy.  May be associated with personality changes such as fear, anxiety, and depression having a major impact on process and perception of chronic pain.

Term

 

Subtypes of Chronic Pain

(4)

Definition

 

1. pain that persists beyond normal healing time

2. pain related to chronic disease

3. pain without identifiable organic cause

4. pain that involves both chronic and acute pain associated with cancer 

Term

 

Nociceptive Pain

 

Definition

Subtypes (2)

Definition

 

Commensurate with identifiable tissue damage; presumably related to ongoing activation of primary afferent neurons in response to noxious stimuli.

 

1. Somatic:  well localized, described as sharp, aching, throbbing

2. Visceral: more diffuse, described as gnawing or cramping

Term

 

Neuropathic Pain

 

Definition

Subtypes (2)

Definition

 

Pain believed to be sustained by aberrent somatosensory processing in the peripheral or central nervous system.

 

1. "Central Generator"-deafferentation pain (central pain, phantom pain)/sympathetically-maintained pain (CRPS)

2.  "Peripheral Generator"-originate in the nerve root, plexus, or nerve/polyneuropathies, mononeuropathies 

Term

 

Idiopathic Pain

Definition

 

Pain, not attributable to identifiable organic or psychologic processes

Term

 

Psychogenic Pain

Definition

 

Sustained by psychologic factors

Term

 

Breakthrough pain

Definition

 

Transient pain, severe or excruciating, over baseline of moderate pain

Term

 

Major Types of Pain/Pain Syndromes

(12)

Definition

1. Acute post-op or trauma pain

2. Acute/chronic pain associated with cancer

3. Chronic non-malignant pain

4. Pain from arthritis (OA and RA)

5. Lower back pain secondary to injury

6. Lower back pain secondary to vertebral fracture or compression

7. Headache/Migraine

8. Post-herpetic neuralgia

9. Peripheral Neuropathy

10. Fibromyalgia

11. Dysmennorhea

12. Phantom limb pain

 

Term

Pathophysiology of Pain

 

 

Definition

Nerve endings activated in response to tissue injury

 

Widely distributed throughout the body

 

Injury tissues release inflammatory substances that activate and sensitive nociceptors

 

Sensitized nociceptors transmit stimuli more intensely and have more spontaneous activity

Term

Pathophysiology of Pain

 

 

Definition

Afferent nerve fibers differ in their rates of impulse transmission

 

A-delta fibers transmit impulses rapidly; well-localized, sharp, stinging pain

 

C fibers transmit impulses more slowly; generalized, lingering dull aches

 

A-beta fibers stimulation have inhibitory effect on pain transmission

 

Ascending and descinding pathways converge in the dorsal horn of the spinal cord; referred pain is possible

Term

 

Pain Receptors

 

Opioid Receptors

 

Endongenous Opioids

(7)

 

Definition

Opioid receptors in the spinal cord and central nervous system impact descending pain signals

 

Endogenous opioids and monoaminergic substances play important roles in the pain transmission system:

 

Beta-endophorins, Dynorphins, Enkephalins, Norepinephrine, Serotonin, Glutamate, GABA 

Term

 

Somatic Pain

 

Characteristics

Treatment (2)

Definition

Constant, well-localized, aching, throbbing

 

Analgesics

Nerve Blocks (Opioid Sensitive)

Term

Visceral Pain

 

Characteristics

Treatment (2)

Definition

Diffuse, deep, dull, cramping, squeezing, referred

 

Analgesics

More complex neurological procedures (opioid sensitive)

Term

 

Neuropathic Pain

 

Characteristics

Treatment (3)

Definition

 

Altered sensations, stabbing, burning, constant or intermittent

 

TCAs

Anticonvulsants

Neurosurgical procedures (Opioid Insensitive)

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