PHR 966- PADIS TEST STUDY
GUIDE
____% of critically ill patients experience pain in the ICU - ANSWER 80
what is the gold standard assessment for patients that can self-report pain? - ANSWER
NRS-V
what does PADIS stand for? - ANSWER pain, agitation, delirium, immobility, sleep
what pain assessment tool is used in for intubated patients? - ANSWER CPOT
what CPOT score requires treatment and what is our goal? - ANSWER treat >2
goal 0-2
what is first-line pharmacologic treatment for pain? - ANSWER IV opioids (CI + bolus)
how can we decrease opioid needs? - ANSWER utilize non-opioid, multimodal approach
T/F you can restart home analgesic medications in the ICU - ANSWER true
what is the MOA of opioids? - ANSWER mu-opioid receptor agonists
what are the 3 common opioids in PADIS? - ANSWER hydromorphone- most
fentanyl
morphine
what are the specific ADRs of hydromorphone? - ANSWER hypotension
constipation
what is the onset and t1/2 of hydromorphone? - ANSWER onset 5-15 min
t1/2 2-3 hrs
what is the metabolism of hydromorphone? - ANSWER hepatic via glucuronidation
what are the specific ADRs of fentanyl? - ANSWER serotonin syndrome
chest wall rigidity
what is the onset and t1/2 of fentanyl? - ANSWER rapid
, onset 1-2 mins
t1/2 2-4 hrs
how is fentanyl metabolized? - ANSWER hepatic via CYP3A4
what are the specific ADRs of morphine? - ANSWER hypotension (most)
histamine release
what is the onset and t1/2 of morphine? - ANSWER onset 5-10 minutes
t1/2 3-4 hours
how is morphine metabolized? - ANSWER hepatic via glucuronidation
what non-opioid pain treatment is most common? - ANSWER APAP
are NSAIDs commonly used in PADIS? - ANSWER no
what are the neuropathic agents for pain? - ANSWER gabapentin
pregabalin
duloxetine, venlafaxine
amitriptyline
what are the muscle relaxant agents for pain? - ANSWER methocarbamol
cyclobenzaprine
baclofen
__-__% of ICU patients experience agitation in ICU - ANSWER 50-70%
what is key in agitation? - ANSWER prevention
-> continually assess sedation
what is the goal-standard sedation scale for agitation and what is the goal? - ANSWER
RASS 0 to -2
what is preferred management of agitation? - ANSWER analgosedation
what is the ideal analgosedative in PADIS? - ANSWER rapid onset and offset
T/F analgosedation should be considered for ALL ICU patients - ANSWER true
T/F SATs and SBTs should be performed daily to assess neurological status - ANSWER
true
-> if fail decrease to 1/2 sedation dose
GUIDE
____% of critically ill patients experience pain in the ICU - ANSWER 80
what is the gold standard assessment for patients that can self-report pain? - ANSWER
NRS-V
what does PADIS stand for? - ANSWER pain, agitation, delirium, immobility, sleep
what pain assessment tool is used in for intubated patients? - ANSWER CPOT
what CPOT score requires treatment and what is our goal? - ANSWER treat >2
goal 0-2
what is first-line pharmacologic treatment for pain? - ANSWER IV opioids (CI + bolus)
how can we decrease opioid needs? - ANSWER utilize non-opioid, multimodal approach
T/F you can restart home analgesic medications in the ICU - ANSWER true
what is the MOA of opioids? - ANSWER mu-opioid receptor agonists
what are the 3 common opioids in PADIS? - ANSWER hydromorphone- most
fentanyl
morphine
what are the specific ADRs of hydromorphone? - ANSWER hypotension
constipation
what is the onset and t1/2 of hydromorphone? - ANSWER onset 5-15 min
t1/2 2-3 hrs
what is the metabolism of hydromorphone? - ANSWER hepatic via glucuronidation
what are the specific ADRs of fentanyl? - ANSWER serotonin syndrome
chest wall rigidity
what is the onset and t1/2 of fentanyl? - ANSWER rapid
, onset 1-2 mins
t1/2 2-4 hrs
how is fentanyl metabolized? - ANSWER hepatic via CYP3A4
what are the specific ADRs of morphine? - ANSWER hypotension (most)
histamine release
what is the onset and t1/2 of morphine? - ANSWER onset 5-10 minutes
t1/2 3-4 hours
how is morphine metabolized? - ANSWER hepatic via glucuronidation
what non-opioid pain treatment is most common? - ANSWER APAP
are NSAIDs commonly used in PADIS? - ANSWER no
what are the neuropathic agents for pain? - ANSWER gabapentin
pregabalin
duloxetine, venlafaxine
amitriptyline
what are the muscle relaxant agents for pain? - ANSWER methocarbamol
cyclobenzaprine
baclofen
__-__% of ICU patients experience agitation in ICU - ANSWER 50-70%
what is key in agitation? - ANSWER prevention
-> continually assess sedation
what is the goal-standard sedation scale for agitation and what is the goal? - ANSWER
RASS 0 to -2
what is preferred management of agitation? - ANSWER analgosedation
what is the ideal analgosedative in PADIS? - ANSWER rapid onset and offset
T/F analgosedation should be considered for ALL ICU patients - ANSWER true
T/F SATs and SBTs should be performed daily to assess neurological status - ANSWER
true
-> if fail decrease to 1/2 sedation dose
