acute pain

< 3 months or as long as it takes for normal healing to
occur sudden subsides with tx

chronic pain

persistant 3-6 months hard to treat; secondary to
changes in the CNS (neuropathic pn) usually cannot
completely get rid of but can get to a tolerable level

somatic pn

originates from skeletal muscles, ligaments and joints

visceral pain

originates from organs and visceral organs

referred pain

occurs when visceral nerve fibers synapse at a level in the
spinal cord close to fibers that supply subcutaneous tissue in the
body EX: pn associated with cholecystitis, often
referred to the back and scapular areas

neuropathic pain

usually results from damage to peripheral or CNS nerve fibers
by disease/injury/idiopathic

phantom pain

occurs in areas of a body part that has been removed
(surgically or traumatically). can also occur in paralyzed
limbs following spinal cord injury

agonist-antagonist

substances that binds to a receptor and causes a partial
response that is not as strong as that caused by an agonist

agonist

substance that binds to a receptor and causes a response

antagonist

drug that binds to a receptor and prevents (blocks) a
response

analgesics

medications that relieve pain without causing loss of
consciousness

addiction

a chronic neurobiologic disease whose development is influence
by genetic psychosocial and environmental factors

adjuvant analgesic drugs

drugs that are added for combined therapy with a primary drug
and may have additive or independent analgesic properties or
both

gate theory

theory that uses the analogy of a gate to describe how impulses
from damaged tissue resented by the brain (proposed by melzack and
the wall 1965)

Non steroidal anti-inflammatory drugs

large chemically diverse group of drugs that are analgesic and
also possess anti-inflammatory and antipyretic activity

opioid analgesics

synthetic drugs that bind to opiate receptors to relieve
pn

opioid tolerance

normal physiological condition in which a larger dose is
required to maintain same level of analgesia abrupt d/c of
rx could result in withdraw sx

What is the name of the drug that reverse the effects of
opioid medications?

Narcan (Naloxone)

What medications are opioid agonists?

codeine, hydrocodone (binds to pn receptor in
brain,blocks connection: reduces pn sensation)

what opioid medications are serve agonists?

morphine, hydromorphone, oxycodone, oxymorphone, methadone

What opioid medications are agonist-antagonists?

pentazocine (Talwin), nubain bind to pn receptors,
weaker response

what are so major adverse effects of opioids?

respiratory depression hypotension
constipation

What is a nursing consideration for the administration of
opioid medications?

DO NOT GIVE if RR is <12

acetaminophen

action: inhibits prostaglandin synthesis
indications: mild to moderate pain
Contraindications: allergy, sever liver disease,
glucose-6-phospate dehydrogenase deficiency (G6PD) (increased risk
of bleeding)

What are the adverse effects of acetaminophen?

rash n/v

What is the total maximum daily dose for acetaminophen?

4000 mg/day

What is the antidote for acetaminophen?

acetylcysteine

what are some nursing implications for acetaminophen?

education alcohol consumption and interaction
elderly

Tramadol

generic name: Ultram central acting analegis
contraindications: seizures, tricyclic
antidepressants, SSRIs, MOIs, neuroleptic, alcohol
side effects: CNS changes, h/a, nausea,
constipation, respiratory depression, seizures

What are side effects of topical anesthetic such as
transdermal lidocaine?

cardiac dysrhythmias, skin irritation

Inflammatory process

localized protective response stimulated by tissue
injury serves to destroy, dilute, wall off injured
tissue s/s: hot, inflammation, swelling, redness
endogenous compounds and pathways

What are some specific NSAID medications?

ASA acetic acid derivatives: indomethacin (indocin),
ketorolac (toradol) propionic acid derivatives: IBU
(Motrin, Advil) Cyclooxygenase-2 inhibitors: celecoxib or
COX-2 inhibitors (Celebrex)