Term
|
Definition
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|
Term
| what are the components of pain? |
|
Definition
perception- physical
Reaction- psychological |
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Term
|
Definition
| cannot tolerate much pain |
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Term
|
Definition
|
|
Term
| what are some factors associated with low pain threshold? |
|
Definition
emotional disabilities
nationality
anxiety/fear
fatigue, sleep deprivation
youth |
|
|
Term
| what are some factors associated with high pain threshold |
|
Definition
sleep
sympathy
activities
analgesics |
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Term
|
Definition
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Term
|
Definition
| dull, lingering, over a long time |
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|
Term
| what are some non drug pain therapies |
|
Definition
acupuncture
biofeedback therapy
massage
heat/cold packs |
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Term
|
Definition
| free nerve endings that transmit pain signals to spinal cord. |
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Term
|
Definition
| p is for pain it is substance used from nociceptors to neuron in pain transmission process. |
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Term
| endogenous neurotransmitter |
|
Definition
| endorphins: make you happy |
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Term
| peripheral area pain transmission process |
|
Definition
-bradykinin is produced with tissue damage and aids with sensory pain impulses
-prostaglandins produce vasodilation for histamine release (swelling)
-prostaglandins activate peripheral NOCICEPTORS that produce pain |
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|
Term
| how can prostaglandins be reduced> |
|
Definition
| cyloooxygenase: an enzyme necessary to produce prostaglandins, no enzyme, no prostaglandins, which means inflammation cannot happen and peripheral nociceptors cannot be notified of pain. so no pain... |
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|
Term
| what are the 2 enzymes that produce prostaglandins made after injury? |
|
Definition
|
|
Term
| what are some chemical mediators released with prostaglandins |
|
Definition
| histamine and bradykinin are chemical mediators that are released with prostaglandins |
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|
Term
|
Definition
celecoxib (celebrex)
Rofecoxin (Vioxx) |
|
|
Term
| what can reduce COX 1 and COX 1 |
|
Definition
|
|
Term
| which cox is most specific |
|
Definition
| cox 2 is most specific, because of this limiting cox 2 limits prostaglandins and it will have fewer side effects. |
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Term
|
Definition
| controlled substance can be natural or synthetic |
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Term
|
Definition
| non controlled substances |
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Term
|
Definition
| drug added to enhance of speed up action of principal ingredient. |
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Term
| two main drugs affect pain |
|
Definition
non narcotic-NSAIDS act at peripheral
and
narcotics: opiods act at CNS |
|
|
Term
| what are 3 types of non narcotic (opiods) |
|
Definition
NSAIDS
ASPIRIN
SELECTIVE COX 2 INHIBITORS |
|
|
Term
|
Definition
antipyretic (fever)
anti-inflammatory(arthritis)
analgesic (pain)
some inhibit cox 2
examples:
*ibuprofen:
Advil, and motrin are oldest
*Naproxin :(naprosyn, anaprox) longer acting and need loading dose. |
|
|
Term
| NSAIDS time table and absorption |
|
Definition
peak in 1-2 hours
food can inhibit absorbtion
metabolized in liver
excreted in kidney
(use causion driving can depress CNS) do not combine with aspirin or any other analgesic. |
|
|
Term
| what are adverse reactions with NSAIDS |
|
Definition
GI irritation, bleeding
CNS depression
interferes with clotting mechanism
affects renal function |
|
|
Term
| contraindicaitons for NSAIDS |
|
Definition
asthma
cardiovascular disease
fluid retention problems
coagulation problems
peptic ulcer/ulcerative colitis |
|
|
Term
| drug interactions with NSAIDS |
|
Definition
lithium-increases levels
digoxin-increases levels
methotrexate-increases levels
antihypertensives-reduces effectiveness
in combo with other anti inflammatory drugs can increase bleeding and hemmorage
do not use alcohol |
|
|
Term
|
Definition
aspirin is anti inflammatory
antipyretic and analgesic.
|
|
|
Term
| what can come from placing aspirin in cheek at site of toothache |
|
Definition
|
|
Term
|
Definition
| common in children from aspirin/ children should be given acetaminophen (TYLENOL) instead. |
|
|
Term
| ringin in ears / hearing loss is symptom of overdose of what drug |
|
Definition
| aspirin overdose=ringin in ears |
|
|
Term
|
Definition
analgesic (ibuprofen)
antipyretic (fever)
often is combined with opiods
provide less gastric discomfort
no anti inflammatory affect
no cardiac or respiratory effect
no anticoagulant effect |
|
|
Term
| problems with acetaminophen |
|
Definition
hepatic necrosis (1 large dose could be fatal)
alcohol stimulates enzymes that metabolize acetaminophen to toxic meatbolite.
kidney disease may occur with prolonged use |
|
|
Term
| where do opiods come from in nature |
|
Definition
|
|
Term
| what are examples of opiod agonists |
|
Definition
morphine -for terminal pts pain/ post op pt.
oxycodone-used alone or combined with aspirin is percodan/ roxiprin. when combined with acetaminophen it is percocet/tylox. (it is the bridge drug between morphine and codeine)
Codeine-used in dentistry. when combined with aspirin it is empirin 3. when combined with acetamenophin it is tylenol 3. used for nausea. (NSAIDS are more effective than this for dental pain)
Proxyphene/darvocet N-100-not used commonly |
|
|
Term
|
Definition
demerol-for post op. mostly in hospital setting
hydromorphone/dilaudid-sever pain, common for addicts, more potent than morphine and better absorbed orally.
fentyanyl-used for anesthesia |
|
|
Term
|
Definition
talwin:
anagesic, sedative, respiratory depression |
|
|
Term
| to reverse effects of opiods give an antagonist. what do you give |
|
Definition
| narcan- has high affinity for receptors and reverses action of opiod(which brings respiration way too low, narcan will normalize it) |
|
|
Term
|
Definition
morphine
demerol
methadone
heroin |
|
|
Term
|
Definition
muscles of head and neck tight due to stress and tension. it is steady lingering pain.
treat with triptans/sumatriptan/imitrex |
|
|
Term
|
Definition
| nitrates, MSG (monosodium glutamate),aura |
|
|
Term
| drugs used to prevent migraines |
|
Definition
beta adrenergic blockers
calcium channel blockers
antidepressants
anti siezure |
|
|
Term
| what are some examples of adjuvant analgesics |
|
Definition
-enhance effect
anticonvulsants and tricyclic antidepressants. |
|
|
Term
|
Definition
used for pain associated with neuralgia
herpes zoster
cancer
(tegretol is a med) |
|
|
Term
| tricyclic antidepressants |
|
Definition
used in treatment for nerve pain
-herpes
-arthritis
-diabetes
-cancer
-migraines
-tension headaches |
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