What is the fifth vital sign? - ANSWER pain
What is pain threshold? - ANSWER level of stimulus needed to create painful sensation
What is pain tolerance? - ANSWER amount of pain one can endure without interfering
with normal functioning.
Somatic pain - ANSWER skin pain
Muscle pain
Tissue pain
Visceral pain - ANSWER organ pain
What are reasons for under treatment of pain? - ANSWER lack of pain assessment
Health professional attitude towards drug seeking
Inaccurate information about addiction
Under dosing
Patient's cultural beliefs
1
,What does unrelieved pain lead to? - ANSWER HTN ***
Increased HR
Increased RR
Pneumonia ***
Urinary retention
Ileus
Confusion
Weakness
What are nonopioid analgesics used for? - ANSWER mild to moderate pain
Good for: dull/throbbing headache pain, dysmenorrhea, inflammation, minor abrasions,
muscular aches, mild-mod arthritis
What are examples of nonopioid analgesics? - ANSWER Acetaminophen (tylenol) --> OTC
NSAIDS --> OTC
1. ASA
2. Ibuprofen (Motrin/Advil)
3. Naproxen (Aleve)
COX2 inhibitors --> Rx
1. Celebrex
2. Vioxx
**Give the analgesic, antipyretic, and anti-inflammatory effects (tylenol not so good for in-
flammation) ***
2
,MOA of NSAIDS - ANSWER block cyclo-oxygenase and inhibit synthesis of prostaglandins
What does the inhibition of Cox-1 and Cox-2 do? - ANSWER decreases inflammation and
pain
What does the inhibition of Cox-1 do? - ANSWER decreases protection of the stomach
lining
Why are Cox-2 blockers better than Cox-1 blockers? - ANSWER they decrease the synthe-
sis of prostaglandins without irritating the stomach
** limit use to 6 months**
What is a concern with all NSAIDS? - ANSWER increased bleeding might occur
What is aspirin? - ANSWER a salicylate NSAID
The oldest nonopioid drug
What syndrome does aspirin play a role in? - ANSWER Reye syndrome
Main SE of ASA? - ANSWER decreased platelet aggregation
Adverse reactions/SE of ASA - ANSWER gastric irritation (if its a cox-1 inhibitor)
Tinnitus (CN VIII) ***
3
, Vertigo
Bronchospasm ***
Urticaria
Who is ASA contraindicated in? - ANSWER children < 19
** children < 19 should not take any salicylates **
When does Reye's syndrome usually occur? - ANSWER when a person is recovering from
a viral illness (chicken pox, influenza) and uses salicylates
What does reye's syndrome cause? - ANSWER severe increase of pressure in brain
Is acetaminophen an NSAID? - ANSWER no
Action of acetaminophen? - ANSWER inhibits prostaglandin synthesis
Uses of acetaminophen - ANSWER relieves pain, discomfort, and fever
What is the maximum dose of acetaminophen per day? - ANSWER 4 g/ day = 4000
mg/day
True or false: Acetaminophen is an anti-inflammatory - ANSWER False
SE of acetaminophen - ANSWER Rash
4
What is pain threshold? - ANSWER level of stimulus needed to create painful sensation
What is pain tolerance? - ANSWER amount of pain one can endure without interfering
with normal functioning.
Somatic pain - ANSWER skin pain
Muscle pain
Tissue pain
Visceral pain - ANSWER organ pain
What are reasons for under treatment of pain? - ANSWER lack of pain assessment
Health professional attitude towards drug seeking
Inaccurate information about addiction
Under dosing
Patient's cultural beliefs
1
,What does unrelieved pain lead to? - ANSWER HTN ***
Increased HR
Increased RR
Pneumonia ***
Urinary retention
Ileus
Confusion
Weakness
What are nonopioid analgesics used for? - ANSWER mild to moderate pain
Good for: dull/throbbing headache pain, dysmenorrhea, inflammation, minor abrasions,
muscular aches, mild-mod arthritis
What are examples of nonopioid analgesics? - ANSWER Acetaminophen (tylenol) --> OTC
NSAIDS --> OTC
1. ASA
2. Ibuprofen (Motrin/Advil)
3. Naproxen (Aleve)
COX2 inhibitors --> Rx
1. Celebrex
2. Vioxx
**Give the analgesic, antipyretic, and anti-inflammatory effects (tylenol not so good for in-
flammation) ***
2
,MOA of NSAIDS - ANSWER block cyclo-oxygenase and inhibit synthesis of prostaglandins
What does the inhibition of Cox-1 and Cox-2 do? - ANSWER decreases inflammation and
pain
What does the inhibition of Cox-1 do? - ANSWER decreases protection of the stomach
lining
Why are Cox-2 blockers better than Cox-1 blockers? - ANSWER they decrease the synthe-
sis of prostaglandins without irritating the stomach
** limit use to 6 months**
What is a concern with all NSAIDS? - ANSWER increased bleeding might occur
What is aspirin? - ANSWER a salicylate NSAID
The oldest nonopioid drug
What syndrome does aspirin play a role in? - ANSWER Reye syndrome
Main SE of ASA? - ANSWER decreased platelet aggregation
Adverse reactions/SE of ASA - ANSWER gastric irritation (if its a cox-1 inhibitor)
Tinnitus (CN VIII) ***
3
, Vertigo
Bronchospasm ***
Urticaria
Who is ASA contraindicated in? - ANSWER children < 19
** children < 19 should not take any salicylates **
When does Reye's syndrome usually occur? - ANSWER when a person is recovering from
a viral illness (chicken pox, influenza) and uses salicylates
What does reye's syndrome cause? - ANSWER severe increase of pressure in brain
Is acetaminophen an NSAID? - ANSWER no
Action of acetaminophen? - ANSWER inhibits prostaglandin synthesis
Uses of acetaminophen - ANSWER relieves pain, discomfort, and fever
What is the maximum dose of acetaminophen per day? - ANSWER 4 g/ day = 4000
mg/day
True or false: Acetaminophen is an anti-inflammatory - ANSWER False
SE of acetaminophen - ANSWER Rash
4
