Term
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Definition
| unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage; whatever a person says it is, existing wherever a person says it does |
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Definition
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Term
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Definition
| requires nurses to assess patients degree of pain, implement in timely manner to provide pain relief, evaluate effectiveness |
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Term
| Pain classification: Nociceptive |
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Definition
| pain resulting from activation of primary afferent receptors by mechanical, thermal, or chemical stimuli |
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Term
| Pain Classification: Neuropathic pain |
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Definition
| results from damage to peripheral nerves or central nervous system tissue or from altered processing of pain in CNS |
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Term
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Definition
| sudden onset, temporary duration, localized: described as stabbing or sharp, accompanied by symptoms of SNS stimulation |
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Term
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Definition
| prolonged; diffuse, difficult to localize, described as ache nagging cramping, symptoms of nausea, fatigue, depression |
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Term
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Definition
| refines perception of pain |
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Term
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Definition
| level of stimulus that results in sensation of pain |
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Term
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Definition
| amount of pain patient can endure without it interfering with normal function |
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Definition
| pain originates from skeletal muscles, ligaments, joints |
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Term
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Definition
| pain originates from organs or smoothe muscles |
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Term
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Definition
| pain experienced in area of body part that has been surgically or traumatically removed |
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Term
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Definition
| pain occurring in an area away from organ of origin |
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Term
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Definition
| pain resulting from any disorder that causes central nervous system damage |
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Term
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Definition
| pain caused, increased, or prolonged by mental, emotional, or behavioral factors |
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Term
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Definition
| pain originates from skin or mucous membranes, opposite of deep pain |
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Term
| Gate theory of pain transmission |
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Definition
| area of spinal cord is "gate" to block impulse transmission; large A fibers close gate, C fibers open gate |
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Term
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Definition
| drug that binds to opiate receptors and produces morphine-like action to relieve pain |
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Term
| Opioid mechanism of action: agonist |
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Definition
| binds with and produces actions at opiate receptors |
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Term
| Opioid mechanism of action: partial agonist |
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Definition
| binds with and produces actions but only at some of receptors |
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Term
| Opioid mechanism of action: mixed agonist-antagonist |
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Definition
| binds with and produces actions with some opiate receptors but blocks others |
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Term
| Opioid mechanism of action: antagonist |
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Definition
| binds with receptors but blocks the receptor |
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Term
| narcotic or opiate analgesics |
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Definition
| action is to mimic endorphins on opiate receptors in brain, altering perception of pain and response |
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Term
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Definition
trade name: demerol
UAD 50-100MG |
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Term
| Generic name: hydromorphone |
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Definition
trade name: dilaudid
UAD 2-4MG |
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Term
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Definition
trade name: sustained release= oxycontin
with tylenol=tylox
with aspirin= percodan
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Term
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Definition
trade: dolophine
narcotic withdrawal |
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Term
| Generic name: propozyphene |
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Definition
trade name: Darvon
with tylenol= darvocet
schedule IV drug |
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Term
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Definition
| trade name in patch: duragesic |
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Term
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Definition
| respiratory depression depth and rate, constipation, nausea and vomiting, sedation, histamine release resulting in itching, vasodilation, orthostatic hypotension, sphincter spasticity leading to biliary colic and urinary retention, euphoria and hallucinations |
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Term
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Definition
trade name: epidural use= Duramorph
sustained release form= MS-Contin
PO Roxanol |
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Term
| Opioid Analgesics: fentanyl |
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Definition
100x potency of morphine
parenteral form: sublimaze for anesthesia
transdermal patch for severe chronic pain such as cancer: duragesic; 24 hours to reach effective level
absorption through oral mucosa= Actiq |
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Term
| Opioid Analgesics: Meperidine (Demerol) |
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Definition
| not recommended beyond 48 hours; short half life requiring frequent dosing; continued use leads to normeperidine, toxic metabolite |
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Term
| Opioid Analgesics: Codeine |
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Definition
| not effective in severe painl commonly combined with tylenol as a cough suppressant |
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Term
| Opioid Analgesics: Oxycodone |
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Definition
Oxycontin- sustained release; significant abuse, tablets crushed or snorted or dissolved in water for IV use;
with acetaminophen= Percocet, Tylox
with aspirin= Percodan |
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Term
| Opioid Analgesics: Heroin |
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Definition
| legal in Europe; high lipid solubility making it cross blood brain barrier and more readily than other opiates |
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Term
| Mixed agonist- antagonist: Petazocine (Talwin) |
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Definition
| works on kappa receptors, antagonist on mu receptors, minimal respiratory depression; doesn't produce euphoria, therefore, minimal abuse potential; increases myocardial workload |
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Term
| Narcotic Antagonists (Antidote) |
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Definition
competes with opiates at opiate receptors leading to reversal of effects of opiates;
treats overdose to reverse respiratory depression;
Naloxone (Narcan) Most common IV, IM, SQ
nalnefane (Revex) IV
naltrexone(ReVia) PO maintenance therapy in opiate addiction |
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Term
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Definition
increased dose required to produce the same effect when pain stimulus remain unchanged
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Term
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Definition
| physical effect of using drug for 10 days or longer |
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Term
| physical withdrawal symptoms of opiates |
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Definition
| runny nose, sweating, anxiety, irritability, abdominal cramps, muscle spasms, goosebumps, diarrhea |
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Term
| salicylates: acetylsalicyclic acid (ASA) or aspirin |
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Definition
Primary SE: GI irritation; adminstration to children with fever as a result of viral illness may lead to Reye's syndrome
toxicity: chronic intoxication (salicylism) or acute salicylate overdose
s/s tinnitus, hyperventilation, acid-base imbalances, seizures
anti-thrombic- prevents blood clots; descreases risk of MI and stroke |
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Term
| salicylates: acetaminophen (Tylenol) |
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Definition
for pain or fever; combined with codeine for pain; no anti-inflammatory effect
major SE: hepatoxicity
Antidote: acetylcysteine (Mucomyst PO form) Acetadote IV form) |
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Term
| NSAIDS: non-steroid anti-inflammatory drugs |
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Definition
many available OTC mild to moderate pain; different classes and sub-classes;
Major SE: GI irritation
concurrent administration of misoprostol (Cytotec) a gastric mucosa protective helps prevent gastric ulcers |
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Term
| NSAIDS: non-steroid anti-inflammatory drugs |
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Definition
most classified as cox-1 inhibitors
propionic acid derivatives such as
ibuprofen (motrin, advil), naproxen (aleve, naprosyn, anaprox), ketoprofen (orudis)
indoles such as ketoralac (toradol)
oxicams
newest class is cox-2 inhibitors: less GI problems
celecoxib (Celebrex) |
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Term
| Other anti-inflammatory drugs |
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Definition
used in severe arthritis unresponsive to other medications; severe SE; take weeks and months to be effective
Glucocorticosteroids (prednisone)
gold products auraofin (Ridaura)
Chemo drugs such as methotrexate
antimalaria drugs such as chloroquine (aralen) |
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Term
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Definition
initial period of drowsiness: 30 min
stage 1 drowsiness 90 min
stage IV deep sleep
characterized by depressed body function, non-rapid eye movement (NREM) non-dreaming physically restorative
after stage IV, 5-20 min of rapid eye movement |
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Term
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Definition
| difficulty falling alseep; staying asleep, both; commonly stress related; medications for short term use |
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Term
| Sedatives, hypnotics, anxiolytics |
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Definition
produce CNS depression: calming, reduce anxiety, promote sleep; symptomatic relief
produce drug tolerance, psychological, physiological dependence; withdrawal symptoms |
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Term
| Sedatives, hypnotics, anxiolytics actions |
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Definition
| potentiate effects of neurotransmitter gamma-aminobutyric acid (GABA), which is inhibitory neurotransmitter in brain; delayed chemical transmission of impulses in retucular formation of brain stem; |
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Term
| side effects of Sedatives, hypnotics, anxiolytics |
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Definition
| excessive drowsiness, hypotention, constipation, hangover feeling |
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Term
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Definition
effect REM and nonREM sleep; not unusual in feeling of not rested, easily agitated, nightmares, frequent awakening on withdrawal
many drug-drug interactions
not commonly used except as adjunct to anesthesia or as anticonculsant
thiopental(pentothal)- anesthesia
pentobarbital (nembutal)- hypnotic
phenobarbital (luminal) anticonvulsant
most are schedule II |
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Term
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Definition
do not suppress REM sleep; wide safety margin between therapeutic and toxic unless combined with other CNS depressants; less rebound, less abuse potential then barbituates but physiological dependence is an issue
schedule IV
long half-lives and metabolism results in active metabolites which prolong further
antidote= flumazenil (romazicon) |
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Term
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Definition
prototype drug diazepam (valium)
alprazolam (xanax)
midazolam (versed) effect of amnesia
lorazepam (ativan)
triazolam (halcion)
"am" family |
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Term
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Definition
effects other than hypnotic; sleep aid
diphenhydramine (benadryl)
doxylamine
hydroxyzine (vistaril, atarax) used as anti-anxiety, adjunct to analgesics |
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Term
| zolpidem (Ambien & ambien CR) |
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Definition
| rapid onset, taken before bedtime; short term use; most commonly prescribed sleeping pill |
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Term
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Definition
| enhances GABA; approved for long term use |
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Term
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Definition
| melatonin receptor agonist; more potent than herbal melatonin; not controlled, no reports of abuse or dependence |
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Term
| Safety measures for sedatives, hypnotics, anxiolytics |
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Definition
| will result in impaired mental and ohysical function; avoid use with activities that require alertness; do not mix with alcohol or other CNS depressants; do not take sleeping pills nightly; |
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