definitions
what is somatic pain
pain from the joints, bones, and muscles that is transmitted by A- fibers. the pain is sharp and well-localized
what is the most prevalent type of natural opioid and what receptors do they bind to
endorphins bind to Mu receptors
describe pain that is associated with A-delta fibers
sharp and well localized
define analgesics
drugs that relieve pain without causing loss of consciousness
what is the general dosing schedule rule when administering opioids?
they should be administered on a fixed schedule
what is modulation
facilitation or inhibition of transmission before, during, or after perception
what is the function of endogenous opioids
bind with opioid receptors to inhibit pain impulses. they are responsible for sensations of well being and modulation of physical processes
describe pain that is associated with c-fibers for acute visceral
poorly localized with an aching, gnawing, throbbing, intermittent cramping quality
what are pure opioid antagonist? when is it given?
blocks opioids and does not produce analgesia or other effects caused by opioid agonists. an example is narcan and is used during opioid overdose
name 3 adverse effects associated with morphine
respiratory depression, constipation, emesis, orthostatic hypotension, pupillary constriction (miosis), and tolerance/physical dependence, urinary retention, cough suppression, biliary colic
what is segmental inhibition of pain
when A-beta fibers signal inhibition interneurons that reduce pain upon movement (rubbing arm)
activation of nociceptors is known as...
transduction
describe referred pain
pain that is distant from its point of origin
infants and elderly are especially sensitive to __(adverse effect)____ caused by ___(drug)___
respiratory depression caused by morphine
one of your patients has overdosed on their opioid medication. what drug can you expect to be administered next?
narcan
what is diffuse noxious inhibitory control (DNIC)
pain that is relieved when two noxious stimuli occur at the same time from different sites such as intense cold or acupuncture
differentiate the types of perception that are associated with the discriminative, affective, and evaluative system
sensory/ discriminative
motivational/ affective
cognitive/ evaluative
burning, shooting, shocklike, or tingling
neuropathic pain
what are the two moderate to strong opioid agonists discussed in class
codeine and oxycodone
what can you recommend to your patient who is experiencing opioid induced constipation
physical activity, increased fluid and fiber intake. laxative or stool softener, enemas
what is the descending inhibitory and facilitatory pathway
it is the pathway that goes down from the brain to the body and inhibits or facilitates pain by activating opioid receptors
list the excitatory and inhibitory neurotransmitters
excitatory: substance P, glutamate, calcitonin
inhibitory: GABA, glycine, serotonin, norepinephrine
what causes central neuropathic pain
lesions or dysfunction in brain or spinal cord
fentanyl is give via what routes and how does it differ from morphine?
parenteral, transdermal, transmucosal and is 100 times the potency of morphine
what should be evaluated with the clinical use of opioids
pain location, characteristics of pain, and duration, things that improve or worsen pain, and status before taking the drug and 1 hour after