PC707-MODULE 5-PAIN EXAM NEW VERSION
2024-2026 LATEST UPDATE WITH VERIFIED
QUESTIONS AND ANSWERS GRADED A
If opioids are needed--how can you decrease the risk of dependence? -
ANSWER>>-smallest dose for the shortest amount of time is advised*
Types of pain: - ANSWER>>-Nociceptive
-Neuropathic
-Mixed or "undetermined etiology"
What is nociceptive pain? - ANSWER>>- pain that arises from damage to or
inflammation of tissue
-Ex: arthropathies, ischemic disorders, myalgias, skin & mucous ulcers, fractures,
renal stones, superficial pain (burns & scrapes), visceral pain (appendicitis,
pancreatitis)
What is neuropathic pain? - ANSWER>>- pain that arises from abnormal or
damaged pain nerves (PNS or CNS)
-Ex: alcoholic or diabetic neuropathies, cancer pain, regional pain syndromes
(fibromyalgia), HIV, MS, phantom limb pain, post herpetic neuralgia, trigeminal
neuralgia, post CVA pain
What is mixed or undetermined etiology pain? - ANSWER>>-chronic reoccurring
headaches
-vasculitis
What is acute & chronic pain? - ANSWER>>Acute-sudden onset & short duration
Chronic-lasts 3-6 months or longer
,What is the step-wise approach to pain management? - ANSWER>>-non-opioids
first (NSAIDs, nonpharmacologic options)
-if pain persists or worsens--weak opioids
-if pain persists or worsens--strong opioids(mathadone, oral admin, transdermal)
-hopefully pain relief at this point--if not potential for nerve block, epidural, PCA
pump, etc.
Key points to remember about pain management: - ANSWER>>-oral analgesics
first if possible*
-give doses at regular intervals & adjust the dose until the patient is comfortable
-prescribe according to pain intensity--it is individualized*
-the correct dose is the one that brings adequate pain relief
-detailed written plan for patient and family
What is an opioid? - ANSWER>>-used for pain relief
-binds to opioid receptors primarily in the CNS, spinal cord, GI tract
-binds primarily to MU receptors and to some extent the KAPPA receptors*
What are the 4 types of pain receptors? - ANSWER>>-MU
-KAPPA
-Delta
-Sigma
What does the binding to MU receptors cause? What drugs bind primarily to
these receptors? - ANSWER>>-Analgesia*
-Respiratory depression*
-Euphoria*
-Ex: morphine (Kadian), meperidine (Demerol), fentanyl (Sublimaze),
hydromorphone hydrochloride (Dilaudid) etc.
What does the binding to KAPPA receptors cause? What drugs bind primarily to
these receptors? - ANSWER>>-Analgesia*
-Sedation*
, -Ex: nalbuphine (Nubain) & butorphanol (Stadol)
What role do delta & sigma pain receptors play? - ANSWER>>-it is not exactly
known
-cause dysphoria & hallucinations*
Why do drugs that bind to primarily MU receptors also cause sedation? -
ANSWER>>-they also bind to KAPPA receptors to some extent--which causes
sedation*
Full opioid agonists: - ANSWER>>-bind to MU receptors in the brain
-produces endorphins which causes the euphoric feeling-which provides pain
relief
Partial opioid agonists: - ANSWER>>-bind to MU receptors in the brain partially
-antagonizes kappa receptors
-produces endorphins but less than a full agonist*
-these are harder to abuse*
-higher affinity than full agonist
-can trigger withdrawal if pt taking full agonists
Ex: buprenorphine (Subutex) or buprenorphine with naloxone (Suboxone)
Examples of strong opioid agonists: - ANSWER>>-morphine, heroin, methadone,
hydromorphone, oxymorphone, meperidine
Examples of moderate opioid agonists: - ANSWER>>-codeine, oxycodone,
hydrocodone, etc.
What are mixed opioid agonist-antagonists? - ANSWER>>-little to no action at the
MU receptors--so decreased risk of respiratory depression
-acts strongly at the KAPPA receptors (causing more sedation)
-caution with patients using full opioid agonists--can also cause withdrawal
-Ex: Stadol & Nubain
2024-2026 LATEST UPDATE WITH VERIFIED
QUESTIONS AND ANSWERS GRADED A
If opioids are needed--how can you decrease the risk of dependence? -
ANSWER>>-smallest dose for the shortest amount of time is advised*
Types of pain: - ANSWER>>-Nociceptive
-Neuropathic
-Mixed or "undetermined etiology"
What is nociceptive pain? - ANSWER>>- pain that arises from damage to or
inflammation of tissue
-Ex: arthropathies, ischemic disorders, myalgias, skin & mucous ulcers, fractures,
renal stones, superficial pain (burns & scrapes), visceral pain (appendicitis,
pancreatitis)
What is neuropathic pain? - ANSWER>>- pain that arises from abnormal or
damaged pain nerves (PNS or CNS)
-Ex: alcoholic or diabetic neuropathies, cancer pain, regional pain syndromes
(fibromyalgia), HIV, MS, phantom limb pain, post herpetic neuralgia, trigeminal
neuralgia, post CVA pain
What is mixed or undetermined etiology pain? - ANSWER>>-chronic reoccurring
headaches
-vasculitis
What is acute & chronic pain? - ANSWER>>Acute-sudden onset & short duration
Chronic-lasts 3-6 months or longer
,What is the step-wise approach to pain management? - ANSWER>>-non-opioids
first (NSAIDs, nonpharmacologic options)
-if pain persists or worsens--weak opioids
-if pain persists or worsens--strong opioids(mathadone, oral admin, transdermal)
-hopefully pain relief at this point--if not potential for nerve block, epidural, PCA
pump, etc.
Key points to remember about pain management: - ANSWER>>-oral analgesics
first if possible*
-give doses at regular intervals & adjust the dose until the patient is comfortable
-prescribe according to pain intensity--it is individualized*
-the correct dose is the one that brings adequate pain relief
-detailed written plan for patient and family
What is an opioid? - ANSWER>>-used for pain relief
-binds to opioid receptors primarily in the CNS, spinal cord, GI tract
-binds primarily to MU receptors and to some extent the KAPPA receptors*
What are the 4 types of pain receptors? - ANSWER>>-MU
-KAPPA
-Delta
-Sigma
What does the binding to MU receptors cause? What drugs bind primarily to
these receptors? - ANSWER>>-Analgesia*
-Respiratory depression*
-Euphoria*
-Ex: morphine (Kadian), meperidine (Demerol), fentanyl (Sublimaze),
hydromorphone hydrochloride (Dilaudid) etc.
What does the binding to KAPPA receptors cause? What drugs bind primarily to
these receptors? - ANSWER>>-Analgesia*
-Sedation*
, -Ex: nalbuphine (Nubain) & butorphanol (Stadol)
What role do delta & sigma pain receptors play? - ANSWER>>-it is not exactly
known
-cause dysphoria & hallucinations*
Why do drugs that bind to primarily MU receptors also cause sedation? -
ANSWER>>-they also bind to KAPPA receptors to some extent--which causes
sedation*
Full opioid agonists: - ANSWER>>-bind to MU receptors in the brain
-produces endorphins which causes the euphoric feeling-which provides pain
relief
Partial opioid agonists: - ANSWER>>-bind to MU receptors in the brain partially
-antagonizes kappa receptors
-produces endorphins but less than a full agonist*
-these are harder to abuse*
-higher affinity than full agonist
-can trigger withdrawal if pt taking full agonists
Ex: buprenorphine (Subutex) or buprenorphine with naloxone (Suboxone)
Examples of strong opioid agonists: - ANSWER>>-morphine, heroin, methadone,
hydromorphone, oxymorphone, meperidine
Examples of moderate opioid agonists: - ANSWER>>-codeine, oxycodone,
hydrocodone, etc.
What are mixed opioid agonist-antagonists? - ANSWER>>-little to no action at the
MU receptors--so decreased risk of respiratory depression
-acts strongly at the KAPPA receptors (causing more sedation)
-caution with patients using full opioid agonists--can also cause withdrawal
-Ex: Stadol & Nubain
