Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > pain > Flashcards

pain Flashcards

1
Q

JCAHO changed pain management

A

mandation: need to document pain, tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

mech of pain management: #1

A

remove cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

mech of pain management: dec. inflammation, irritation, sensitivity of nerve endings

A

aspirin (prototype NSAID), NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

mech of pain management: block conduction of impulses by pain fibers

A

local anesthetics (lidocaine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

mech of pain management: modify processing of pain info in CNS

A

opioids: morphine
others: aspirin, acetominophen, NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

aspirin, ibuprofen, NSAIDs work via

A
  • inhib. prostaglandin synthesis (COX-1, COX-2)
  • alleviate pain by acting at nerve endings and in CNS
  • antiinflammatory effects contribute to pain relief
  • pain relieving dose is less than anti-inflammatory dose*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

aspirin, ibuprofen, NSAIDs side effects

A

GI: irritation, bleeding
CV: HTN, MI, stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pain pathway

A

nociceptors–>afferent fibers–>DRG–>substantia gelatinosa–>STT–>thalamus–>TO BOTH: sensory cortex (feel the pain) and limbic system (emotional response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pain mediators

A

endorphins, enkephalins, serotonin, NE, substance P, prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

opioids work primarily on the…

A

limbic system; pain does not cause as much distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

acetaminophen works via

A

inhib. PG syn. in CNS nerve endings (not in periphery)

also alleviates pain at nerve endings in CNS (unclear mech)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acetaminophen does NOT

A

affect inflammation

cause GI irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acetaminophen risks

A

hepatotoxicity at high doses (4 g/day)

*not only a problem with OD, ALSO with moderate doses if other risk factors (hepatitis, etOH) (2.5-3 g/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

NSAIDs also have

A

anti-pyretic activity (lower fever)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ketorolac (Toradol)

A

ACUTE pain management (not as much for anti inflammatory)
musculoskeletal, post-op, visceral (kidney stone, gall bladder stones)

injectable NSAID
-alt. to opioid for pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

selective COX-2 inhibs action

A

prev. anti-inflammatory affects w/out red. in COX-1 activity (important prostaglandins in upper GI “good guys” that inhib. acid prod. and is mucus producing)

17
Q

selective COX-2 inhibs

A

celocoxib (Celebrex) -not as bad SE as other 2
rofecoxib (Vioxx)
valdecoxib (Bextra)

18
Q

COX-2 is not always bad

A

maintain renal perfusion (COX-1)
produce prostacyclin:
vasodilate coronary vessels & inhibit plateled aggretation

19
Q

even selective COX-2 inhibitor use can cause

A

inc. renin–>inc. aldosterone–>inc. Na retention–>HTN (COX-1 as well)

prostacyclin prod. prevented–>coronary
constriction and uninhibited platelet aggregation–>coronary HTN, heart attack, stroke

20
Q

NSAIDs and etOH

A

contribute to HTN

21
Q

problems with Ketorolac (Toradol)

A

causes GI irritation one of the worst!

ok for short term (1-2 days) not chronic

22
Q

local anesthetics

A

-block sodium channels in nerve endings and axons and stop gen/cond of APs
small unmyelinated neurons are most sensitive
(type C pain fibers)
high enough conc. can affect motor neurons: spinal, regional, nerve block techniques
invasive procedures–>affect motor function and sensory modalities

23
Q

newer low dose protocols of local anesthetics

A

more selective pain relief withough affecting other functions (+influsion pumps)

24
Q

opioids

A

most effective drugs for sev. pain
under-utilized bc of legal issues and fear of addiction
-this should not prevent use for app. pain management

25
Q

opiod receptors

A

u agonists are most powerful: morphine, hydromorphone, less: pentazocine, Buprenorphine
kappa: pentazocine, nalbuphine
gamma:
MORE

26
Q

u agonists also…

A

have greatest abuse potential (euphoria)

27
Q

scheduling of controlled substances

A

analyze medical benefits vs physical dependence

28
Q

Schedule 1 opioids:

A

heroine, etc DO NOT PRESCRIBE

29
Q

Schedule 2 opioids:

A

morphine, dilaudid, percusate (hydrocodone) 30 day supply, non-refill
high abuse potential req. to be reported
can
must be taper prescriptions
can pre-prescribe

30
Q

Schedule 3 opioids:

A

codeine (used for mild-mod pain
vicodin (hydrocodone+ acetominophen) moved from 3 to 2!!
6 month refill potential at 1 month increments

31
Q

vicodin

A

5 mg hydrocodone + 500 mg acetaminophen (do not exceed 8/day)

32
Q

if sev. pain

A

stay away from combo products MORE

33
Q

pain management & cost effectiveness

A

cost of appropriate pain management easy to consider

-not so easy: cost of inadequate pain management: ER visits, surgery, negative effect on life

Pharm (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions