Pharmacology 4 0.0 / 5 ? NursingPharmacologyUniversityAll boards Created by: evepoagCreated on: 19-10-22 17:07 What are the 3 types of pain? 1. Acute (under 3 months) 2. Chronic (over 3 months) 3. Cancer pain 1 of 37 Describe nociceptive pain It is caused by an external injury, and causes feelings of sharpness, stabbing and aches 2 of 37 What receptors are triggered in nocipetive pain? Nociceptors 3 of 37 Describe neuropathic pain It is caused by damage to the nerves, and causes feelings of burning 4 of 37 How do nociceptors work? Free nerve endings pick up the stimulus information and convert it into a nerve signal to transmit to the spinal cord 5 of 37 Name 4 types of analgesia 1. Opioids 2. NSAIDS 3. Paracetamol 4. Local anaesthetics 6 of 37 What are opioids? A naturally-occurring substance from the opium poppy seed that binds to receptors 7 of 37 Opioid receptors signal to which body systems? Peripheral and central nervous systems, and the gastrointestinal system 8 of 37 Where is morphine metabolised? The liver 9 of 37 What are the side effects of opioids? Respiratory depression Drowsiness Nausea and vomitting Hypotension 10 of 37 What drug is used to reverse opioid overdose? Naloxone 11 of 37 How does naloxone work? Naloxone has a higher affinity to the opioid receptors than opioids, so it knocks the opioids off the receptors for a short time 12 of 37 What is patient-controlled analgesia (PCA)? Patient controls their own pain medication, it can be administer every 5 minutes 13 of 37 What is nurse-controlled analgesia (NCA)? Adults have an NCA if they cannot administer themselves 14 of 37 What are the 3 types of central nerve blocking for pain? - Caudal - Spinal - Epidural 15 of 37 When are spinal blocks used and what is important to monitor afterward? During caesarean sections It is important to monitor leg movement postoperatively 16 of 37 When are caudal blocks used? In young children as it is easily accessible, usually postoperatively 17 of 37 What is an epidural made up of? Fentanyl and levobupivacaine 18 of 37 What kind of analgesia is an epidural? Local anaesthetic and opioid 19 of 37 What is a 'pain buster' infusion? A continuous pump of local anaesthetic infusion 20 of 37 What is important to monitor when using local anaesthetic infusions? Toxicity 21 of 37 Name a few non-pharmacological pain relief methods TENS Heat and cold packs Acupuncture 22 of 37 A young child needs to have an IV line inserted. How might you support them? - Include family - distraction techniques - local anaesthetic numbing cream - entonox 23 of 37 What is a major social issue concerning analgesia? Addiction 24 of 37 Pain is sensed by which nerves and perceived and changed by what? pain is sensed by the peripheral nerves and perceived and changed in the brain and central nervous system 25 of 37 What does NSAIDs stand for? Non-Steroidal Anti-Inflammatory drugs 26 of 37 How do NSAIDs work? Damage to immune cells causes the release of prostaglandins. NSAIDs reduce the production of prostaglandins by blocking the COX enzyme 27 of 37 What do prostaglandins do? They bind to receptors on the nerve endings, sensitising them to pain, lowering the activation threshold, meaning more pain messages reach the brain. However, they also cause redness and swelling 28 of 37 By inhibiting prostaglandin production, what therapeutic effect does this have? It results in less pain, decreased heat and swelling 29 of 37 Inhibiting prostaglandins production can have negative effects. What are prostaglandins IMPORTANT for? They reduce acid production in the gastric mucosa 30 of 37 Without prostaglandins, what can happen? NSAIDs can cause GI ulcers 31 of 37 What should be prescribed with NSAIDs if someone is at risk? PPIs - proton pump inhibitors They reduce stomach acid production 32 of 37 What positive effect do prostaglandins also have? They keep airway in lungs open, and help maintain renal blood flow. Use of NSAIDs can result in renal impairments and worsening asthmatic symptoms 33 of 37 What 4 drugs have narrow therapeutic ranges? Digoxin Gentamycin Vancomycin Lithium 34 of 37 What condition should be avoided with NSAIDs? Active gastro-intestinal ulceration 35 of 37 Paracetamol is NOT an opioid. Therefore, what should NOT be given to reverse overdose? Naloxone should NOT be given in a paracetamol overdose 36 of 37 If a drug has a narrow therapeutic range, what must be done? Regular blood samples to monitor serum concentrations of the drug 37 of 37
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