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Terms in this set (70)
-Referred Pain
• Pain that is present in an area removed or distant from its point of
origin
-Acute Somatic Pain
• Arises from connective tissue, muscle, bone & skin
• Sharp & localized or dull & non-localized
• Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates,
local anesthetics, ice, massage
Types of Acute Pain
-Acute visceral pain
• Pain in the internal organs & abdomen
• Poorly localized (C-fibers)
• Radiates
• Most responsive to opiates
• May also use corticosteroids, NSAIDs
*rated by severity
-inflammation
• redness
inflammatory response • swelling
• heat
• pain
, small proteins cells release as a signaling mechanism
chemokines -best known for their ability to stimulate the migration of cells, most
notably white blood cells (leukocytes).
-release histamine
• goes to endothelial cells that line capillaries, makes capillaries larger
mast cells
(vasodilation), causing swelling, capillary walls become more porous
(things get through more easily)
phagocytes
first responders
neutrophils
the passage of blood cells through the intact walls of the capillaries,
diapedesis
typically accompanying inflammation.
extravasation escape of fluid from a blood vessel into surrounding tissue
pain is influenced by: gender, genetics, social, cultural, and personal factors
Acute pain has an occurrence of three months
fewer than __________ -often precipitated by trauma & acute medical conditions or tx
-reducing the intensity of pain while enhancing physical &
psychological functioning
-common goal is to resume the activities of daily life
-Complete elimination of pain is often not realistic if the source of pain
Treatment goals about pain relief:
continues to exist
Considerations
• finding the lowest effective dose to achieve tolerable pain levels is
paramount
-Non-pharmacological treatments may also be considered to promote
comfort
-Patient factors
• age, ethnicity, gender, the presence of hepatic and/or renal
impairment, genetic polymorphisms, and/or coexisting
Appropriate selection of
cardiorespiratory or cerebrovascular disease
medications includes:
-Drug factors
• drug metabolism, receptor binding strength, potential for drug-drug
interactions, and/or co-administration with other CNS depressants
-Opioids
-Acetaminophen
commonly used agents for acute
-NSAIDs
pain management
-Salicylates
-COX-2 Inhibitors
, -Drug Indication:
• Moderate to severe pain
-Dosing Considerations:
• Opioid naïve vs chronic pain pt
-Adverse Drug Reactions:
• Sedation, drowsiness, mental clouding; constipation; nausea &
decreased appetite; sexual dysfunction; tolerance/ dependency
• ADRs worse when combined with alcohol or benzodiazepines
Opioids
-Patient Education:
• Clear instructions regarding safety & ADRs
• discuss length of tx; discuss non-opiate therapy
-Monitoring:
• Is pain medication effective? Is the dose being tapered or
discontinued? If not reassess cause of pain.
-Drug Interaction:
• Any other drug that causes a sedative effect.
-Drug Indication:
• Mild to moderate pain
-Dosing Considerations: Dose appropriately
• Mild pain: 325 to 650 mg q4-6 hrs
• Children: 10/kg/mg every 4 to 8 hours
• Moderate pain: 500 to 1,000 mg q4-6 hrs drugging indication used for
fever
• Max: 4 gms/ 24 hrs use for fever &/or pain
• Children: 15 mg/kg/dose
-Adverse Drug Reactions:
Acetaminophen • Usually well-tolerated
• Hepatic injury with overdose
• Renal disease with chronic use
-Drug interactions:
• alcohol
-Patient Education:
• Do not exceed maximum dose (4gm/24 hours)
-Monitoring:
• Monitor for effectiveness. May need to add an opioid agonist
-Drug Interaction:
• None