pain meds 1

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pain meds 1
2010-05-03 10:48:22
pain meds

pain meds 1
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  1. What is pain?
    • a common symptom subjective experience
    • defense mechanism
  2. Pain theory
    tissue damage activates the free nerve ending (pain receptors or nocieptors) of peripheral nerves
  3. Chronic Pain
    lasts longer than 6 months
  4. Pain is the _______ vital sign
  5. Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)
    emphasizes importance of pain and it's management for all patients
  6. Assessment of Pain
    Patient's own perception numerical scale for uniformity
  7. Use what to assess for pain?
    quality duration onset intensity
  8. Acute Pain
    usually from injury to recovery for a defined period of time, usually less than 6 months
  9. Chronic Pain
    lasts longer than 6 months
  10. Non-Pharmacological Pain Management
    acupuncture biofeedback massage heat/cold relaxation chiropractics hypnosis music therapy
  11. Alagesics
    medications to relieve pain
  12. 2 main classes of medication
    • 1. NSAIDS
    • 2. Narcotic
  13. NSAIDS
    non-steroidal anti-inflammatory drugs aka non-opioids
  14. How do NSAIDS work?
    act at the peripheral level
  15. Narcotic
    Opioid analgesics
  16. How do Opioids work?
    act in the CNS
  17. Opiates "or ""Opium"
    milky extract of unripe sees of the poppy plant
  18. How do opiates or opium work?
    act like morphine in the body
  19. "Natural ""morphine-like"" substance"
    Synthetic Opioids
  20. Narcotic- morphine like drugs - produces analgesia - produces CNS depression - can be Natural - morphine - can be synthetic - meperidine (Demerol)
    Opioids narcotic substances
  21. How do opioids work?
    produce numbness or stupor-like symptoms
  22. Opioids interact with what?
    at least 6 receptor type cells
  23. Opioids focus on what?
    mu and kappa receptors
  24. Opioids are
  25. what is the desired response for opioids?
  26. Opioids are a scheduled ___ drug
    II, highly abusive
  27. Opioids analgesics reduces
    severe pain
  28. Opioids produce what type of symptoms?
    numbness or stupor-like symptoms
  29. How do opioids produce numbness?
    inhibits production of pain and inflammation by prostaglandins in peripheral tissues
  30. Therapueutic actions of opioid analgesics
    - widespread pharmacologic effects especially in CNS and GI systems - Produces analgesia
  31. Opioid Analgesics act mostly on ?
  32. Opioid Analgesics inhibits transmission of pain signals from...
    peripheral tissues to the brain
  33. how does opioid anagesics produce analgesia
    - reduces perception of pain - causes CNS depression - drowsiness-sleep-unconscious - decreases physical and mental activity
  34. Opioid Agents Mechanism of Action
    • Binds to opioid receptors in brain and spinal cord
    • powerful CNA depressant
  35. Powerful CNS depressant
    - cause sedation - euphoria - intense relaxation - highly abusive
  36. Opioids Pharmacokinectics
    - IV administration most reliable to achieve therapeutic levels 100% bioavailability
  37. opioid are better absorbed with what administration?
    IM, oral, subq
  38. opioids are absorbed faster in male or female?
  39. other routes of opioids?
    epidural, intrathecally (directly into spinal column)
  40. oral drugs undergo significant
    "first-pass" metabolism
  41. which form of opioids require increased dosages?
  42. opioid metabolites are excreted in the
  43. Opioid is DOC for what symptom?
    severe pain
  44. morphine is the prototype drug for?
    severe pain
  45. Do opioids lower pain thresholds
  46. Do opioids block transmission of pain?
  47. what is the pharmocology of opioids?
    alters the perception and emotional reponse to pain.
  48. Reason opioids are abused?
    produces euphoria and intense relaxation
  49. Clinical Indications for opioids
    Prevent or relieve acute or chronic pain
  50. what are other uses for opioids other than pain relief?
    - suppresses cough reflex center (Codeine) - slows motility of GI tract in severe diarrhea (Paragoric)
  51. Adverse Reactions of Opioids
    - Potentially life threatening - Respiratory Depression - Sedation/Somulence - Nausea/Vomiting/Constipation - Orthostatic Hypotension
  52. Respiratory Depression in opioids
    activation of the "mu" receptors in CNS mu receptors are primarily pain blocking receptors most serious adverse effect of this class of drug
  53. why do opioids have the potential for physical/psychological dependence?
    • more likely to occur with higher doses for extended periods
    • Who is more likely to undermedicate?
    • healthcare workers
  54. what happens when patients under-medicate?
    energy expended in coping with pain pain management = increased healing time
  55. Opioids Contraindications & cautions
    respiratory depression COPD Liver disease renal disease BPH (urinary retention) increased ICP allergy