Pharmacological Management
Adaptation to a drug causing withdrawal when the drug is stopped
Physical dependence
Acronym used for a thorough pain assessment
PQRSTUV
The use of electrical current through electrodes to reduce pain
TENS (transcutaneous electrical nerve stimulation)
An expected side effect of opiods that does NOT decrease with time
Constipation
The 2 types of pain that people experience
Nociceptive
Neuropathic
Preferred route of drug administratino for chronic pain
Oral (as long as functioning GI) or transdermal
Most important vital sign to assess before administering an opioid
Respiratory rate
2 “physical” interventions for pain management
Massage, exercise, Heat / cold, acupuncture,
Medication used to reverse respiratory depression related to narcotics use
Naloxone
An appropriate pain scale for use with a 5 year old
Faces pain scale
Type of drug therapy you would expect when patient rates pain as 3/10
non-opiods (e.g. NSAIDs, Tylenol)
Three criteria on the opiod risk assessment tool
Family hx of substance abuse
Personal hx of substance abuse
Age (16 – 45)
Hx of preadolescent sexual abuse
Psychological disease
The use of local anesthetics to interrupt transmission of nociceptive input and prevent pain
Nerve blocks
Antiemetics are used to treat these two common side effects
Nausea and vomiting
The generalized itchy feeling that some people on opiods get
Pruritis
4 types of patients requiring special consideration for opioid use
Older adults (>65)
Compromised renal and hepatic function
Pregnant women
Pts with sleep disorders / obstructive sleep apnea
Pts with depressed mood or anxiety
Substance abuse
Adverse health behaviours (e.g. tobacco use, alcohol use, obesity, substance abuse history)
What the 2 item chronic pain scale assesses
Pain intensity (scale of 0 – 10)
Pain interference (how interfered with daily activities – scale of 0 – 10)
3 “psychological” interventions for pain management
CBT, music, distraction, relaxation, education, energy flow
Increased HR & BP, pupillary dilation, anxiety, goose bumps and jittery behaviour are signs of this
Opioid withdrawal
3 barriers to pain management
Fear of addiction, fear of tolerance, concern about adverse events, desire to be a good pt, desire to be stoic, forgetting to take meds, concern that pain signifies disease progression, fear of distracting the health care provider from treating the disease, sense of fatalism, ineffectiveness of medication
3 adjuvant medications used to manage pain
Antidepressants
Antiseizure
Muscle relaxants
Cannabinoids
Psychostimulants
Anesthetics
What the FLACC tool assesses in children
Facial expression
Leg movement
Activity
Cry
Consolability
2 “self-management” strategies for pain management
Energy conservation, pacing, sleep promotion, relaxation, communication skills, safe exercise – goals are set to increase functional capacity and emotional well being
3 adverse effects of opioid use that diminish with time
Sedation
Nausea
Urinary retention
3 important points to include when health teaching someone about opiod use
Dosing, stopping the med, side effects, not to take sedative drugs, how to get rid of unused meds