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