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Pain Management
Exam 2
34
Art/Design
5th Grade
09/23/2013

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Cards

Term
what makes pain better/worse
Definition
preventative/provocative
Term
describe the pain; classify the type
Definition
quality
Term
radiation
Definition
where is the pain? is it localized?
Term
severity
Definition
pain scale- give a reference point
Term
temporal
Definition
any specific time pain is worse? how long does it last?
Term
dull, aching, throbbing, localized, worse with movement
Definition
somatic
Term
irritable bowel pain, gas pain
Definition
visceral
Term
lightening, streaking, radiating, pins and needles, electrical
Definition
neuropathic
Term
Charlie horse, gripping, spasms
Definition
muscle spasm
Term
typically able to self-treat with OTC APAP or an NSAID
Definition
mild pain
Term
combination of medications (hydrocodone + APAP)
Definition
moderate pain
Term
opioids or IV medication
Definition
severe pain
Term
somatic pain treatment
Definition
opioids, NSAIDs, calcitonin, bisphosphonates, steroids, radiation
Term
visceral pain treatment
Definition
nerve blocks, intrathecal with opioid and/or local anesthetic, epidural, octreotide to decrease secretions in bowel obstructions, antispasmodicss
Term
inhibits the synthesis of prostaglandins via COX in the CNS; blocks pain impulse in the periphery
Definition
acetaminophen
Term
neuropathic pain treatment
Definition
TCAs, SNRIs, anticonvulsants, topiramate, capsaicin, Lidoderm patches, steroids, opioids
Term
Not to exceed 2 grams/day (acetaminophen)
Definition
Alcoholics
Term
Acetaminophen Clinical pearls
Definition
DOC for pain in pregnancy, DOC for pain in patients on warfarin; FDA is limiting combo productions to 325 mg/dose
Term
inhibit COX enzymes in the CNS and PNS; COX enzymes catalyze prostaglandins and thromboxane from arachadonic acid; Prostaglandins increase inflammation
Definition
NSAIDs
Term
non-selective NSAIDs
Definition
Ibuprofen, Naproxen
Term
Cox-2 selective NSAID
Definition
Celecoxib (Celebrex)
Term
used for severe pain; avoid in patients with renal failure or a high risk of bleeding
Definition
Ketorolac (Toradol)
Term
NSAID contraindication
Definition
treatment of peri-operative pain in the setting of coronary artery bypass graft CABG) surgery
Term
interaction with the MOR-1D receptor which subsequently connects to GRPR to relay itch signals
Definition
Pruritus
Term
Pruritus treatments
Definition
Antihistamines, change opioid, steroid
Term
activation of opioid receptors in the chemotherapy trigger zone. this triggers a signal to the omitting center to initiate emesis
Definition
nausea and vomiting
Term
interaction with the mu-2 opioid receptors in the brain
Definition
respiratory depression
Term
Morphine advantages
Definition
multiple routes and formulations, most experience
Term
morphine disadvantages
Definition
highest rates of side effects
Term
can be opened and sprinkled into food
Definition
Kadian
Term
Morphine 6-glucuronide
Definition
analgesic properties
Term
Morphine 3-glucuronide
Definition
toxic, can accumulate in patients with renal failure and may lead to seizures
Term
hydromorphone advantages
Definition
more potent, faster onset, no major metabolites, lower rate of side effects compared to morphine, a once daily ER formulation
Term
hydromorphone disadvantages
Definition
more expensive, less formulations, higher risk
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