Physical dependence body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased Tolerance body becomes accustomed to opioid and need larger doses Neuropathic pain caused by lesion or disease of peripheral or central somatosensory nervous system Postherpetic neuralgia follows acute CNS infection (ex. herpes zoster - shingles) Cutaneous pain superficial; involves skin or SQ tissue; ex. paper cut EMLA cream cover w/ occlusive dressing 1hr prior to procedure for local pain relief 30 degrees HOB elevation for epidural analgesia FLACC pain scale for 2 months to 7 years prostaglandins send additional pain stimuli to CNS nociceptors peripheral/pain receptors; respond to selective stimuli PCA pump to be operated by patient only addiction chronic, relapsing brain disease; compulsive drug seeking acute pain rapid in onset; mild to severe; protective in nature serotonin stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction BP, O2 sat, RR Pertinent VS to monitor with PCA or Epidural analgesia NSAIDs Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks Diversion any act that results in a controlled drug not reaching the prescribed pt Multimodal analgesic therapy combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief enkephalins inhibit release of substance P to reduce pain sensation Visceral pain poorly localized; originates in thorax, cranium and abdomen; usually r/t disease Gate Control Theory pain is believed to be controlled by closing the gating mechanism in the spinal cord transduction activation of pain receptors pain it is what pt says it is Phantom pain does not have an identifiable physiologic or pathologic cause; ex. amputation Pain tolerance max intensity of stimulus that produces pain a person is willing to accept Nociceptive pain represented by normal pain process modulation process by which the sensation of pain is inhibited or modified Somatic pain diffuse; originate in tendons, ligaments, bones blood vessels or nerves substance P sensitizes receptors on nerves to feel pain; increase nerve firing rate Acetaminophen viewed as one of the safest & best- tolerated analgesics chronic pain persists or recurrent greater than 3 months placebo sham med or procedure designed and known to not be of any therapeutic clinical value Oral (po) Preferred route of medication for cancer pain endorphins powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria Pasero Opioid- Induced Sedation Scale used to assess respiratory depression S1234 Sharp quality of pain that is stabbing and intense nocebo harmful or undesirable response from placebo Opioid analgesic Assess for respiratory depression with these meds; reversal Narcan (naloxone) Cutaneous stimulation massage; heat/cold therapy; acupressure; TENS unit transmission pain sensation from site of injury or inflammation travel to spinal cord then brain bradykinin vasodilator; triggers release of histamine; assists in inflammation s/s Intractable pain resistant to therapy; no relief from interventions referred pain pain originates in one part of body but perceived in area distant from point of origin Breakthrough pain temporary flare- up of mod.- severe pain that occurs with ATC (around the clock) meds Nociplastic pain chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic Hypnosis produces a subconscious state accomplished by suggestions made by hypnotist CRIES pain scale used for neonates (0-6mo.) pain threshold min. intensity of a stimulus that is perceived as painful Physical dependence body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased Tolerance body becomes accustomed to opioid and need larger doses Neuropathic pain caused by lesion or disease of peripheral or central somatosensory nervous system Postherpetic neuralgia follows acute CNS infection (ex. herpes zoster - shingles) Cutaneous pain superficial; involves skin or SQ tissue; ex. paper cut EMLA cream cover w/ occlusive dressing 1hr prior to procedure for local pain relief 30 degrees HOB elevation for epidural analgesia FLACC pain scale for 2 months to 7 years prostaglandins send additional pain stimuli to CNS nociceptors peripheral/pain receptors; respond to selective stimuli PCA pump to be operated by patient only addiction chronic, relapsing brain disease; compulsive drug seeking acute pain rapid in onset; mild to severe; protective in nature serotonin stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction BP, O2 sat, RR Pertinent VS to monitor with PCA or Epidural analgesia NSAIDs Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks Diversion any act that results in a controlled drug not reaching the prescribed pt Multimodal analgesic therapy combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief enkephalins inhibit release of substance P to reduce pain sensation Visceral pain poorly localized; originates in thorax, cranium and abdomen; usually r/t disease Gate Control Theory pain is believed to be controlled by closing the gating mechanism in the spinal cord transduction activation of pain receptors pain it is what pt says it is Phantom pain does not have an identifiable physiologic or pathologic cause; ex. amputation Pain tolerance max intensity of stimulus that produces pain a person is willing to accept Nociceptive pain represented by normal pain process modulation process by which the sensation of pain is inhibited or modified Somatic pain diffuse; originate in tendons, ligaments, bones blood vessels or nerves substance P sensitizes receptors on nerves to feel pain; increase nerve firing rate Acetaminophen viewed as one of the safest & best- tolerated analgesics chronic pain persists or recurrent greater than 3 months placebo sham med or procedure designed and known to not be of any therapeutic clinical value Oral (po) Preferred route of medication for cancer pain endorphins powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria Pasero Opioid- Induced Sedation Scale used to assess respiratory depression S1234 Sharp quality of pain that is stabbing and intense nocebo harmful or undesirable response from placebo Opioid analgesic Assess for respiratory depression with these meds; reversal Narcan (naloxone) Cutaneous stimulation massage; heat/cold therapy; acupressure; TENS unit transmission pain sensation from site of injury or inflammation travel to spinal cord then brain bradykinin vasodilator; triggers release of histamine; assists in inflammation s/s Intractable pain resistant to therapy; no relief from interventions referred pain pain originates in one part of body but perceived in area distant from point of origin Breakthrough pain temporary flare- up of mod.- severe pain that occurs with ATC (around the clock) meds Nociplastic pain chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic Hypnosis produces a subconscious state accomplished by suggestions made by hypnotist CRIES pain scale used for neonates (0-6mo.) pain threshold min. intensity of a stimulus that is perceived as painful
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body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased
body becomes accustomed to opioid and need larger doses
caused by lesion or disease of peripheral or central somatosensory nervous system
follows acute CNS infection (ex. herpes zoster - shingles)
superficial; involves skin or SQ tissue; ex. paper cut
cover w/ occlusive dressing 1hr prior to procedure for local pain relief
HOB elevation for epidural analgesia
pain scale for 2 months to 7 years
send additional pain stimuli to CNS
peripheral/pain receptors; respond to selective stimuli
to be operated by patient only
chronic, relapsing brain disease; compulsive drug seeking
rapid in onset; mild to severe; protective in nature
stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction
Pertinent VS to monitor with PCA or Epidural analgesia
Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks
any act that results in a controlled drug not reaching the prescribed pt
combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief
inhibit release of substance P to reduce pain sensation
poorly localized; originates in thorax, cranium and abdomen; usually r/t disease
pain is believed to be controlled by closing the gating mechanism in the spinal cord
activation of pain receptors
it is what pt says it is
does not have an identifiable physiologic or pathologic cause; ex. amputation
max intensity of stimulus that produces pain a person is willing to accept
represented by normal pain process
process by which the sensation of pain is inhibited or modified
diffuse; originate in tendons, ligaments, bones blood vessels or nerves
sensitizes receptors on nerves to feel pain; increase nerve firing rate
viewed as one of the safest & best-tolerated analgesics
persists or recurrent greater than 3 months
sham med or procedure designed and known to not be of any therapeutic clinical value
Preferred route of medication for cancer pain
powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria
used to assess respiratory depression S1234
quality of pain that is stabbing and intense
harmful or undesirable response from placebo
Assess for respiratory depression with these meds; reversal Narcan (naloxone)
massage; heat/cold therapy; acupressure; TENS unit
pain sensation from site of injury or inflammation travel to spinal cord then brain
vasodilator; triggers release of histamine; assists in inflammation s/s
resistant to therapy; no relief from interventions
pain originates in one part of body but perceived in area distant from point of origin
temporary flare-up of mod.-severe pain that occurs with ATC (around the clock) meds
chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic
produces a subconscious state accomplished by suggestions made by hypnotist
pain scale used for neonates (0-6mo.)
min. intensity of a stimulus that is perceived as painful
