NR 293 FINAL EXAM PHARM

1 NR 293 FINAL EXAM PHARM Chapter 10 Analgesics  Medications that relieve pain without causing loss of consciousness  “Painkillers”  Opioid analgesics  Adjuvant analgesic Pain Threshold  Level of stimulus needed to produce the perception of pain  A measure of the physiologic response of the nervous system Pain Tolerance  The amount of pain a person can endure without it interfering with normal function  Varies from person to person  Subjective response to pain, not a physiologic function  Varies by attitude, environment, culture, ethnicity  Pain by Onset and Duration Acute pain Sudden onset Usually subsides once treated Chronic pain Persistent or recurring Lasts 3 to 6 months Pain Transmission  Tissue injury causes the release of the following: Bradykinin Histamine Potassium Prostaglandins Serotonin  These substances stimulate nerve endings, starting the pain process.  Rubbing a painful area with massage or liniment stimulates large sensory fibers  Result Closes gate Reduces pain sensation Adjuvant Drugs  Assist primary drugs in relieving pain NSAIDs Antidepressants Anticonvulsants Corticosteroids  Example: adjuvant drugs for neuropathic pain Amitriptyline (antidepressant) Gabapentin or pregabalin (anticonvulsants) World health organization 3-Step Analgesic Ladder  Step 1: non-opioids (with or without adjuvant medications) after the pain has been identified and assessed. If pain persists or increases, treatment moves to  Step 2: opioids with or without non-opioids and with or without adjuvants. If pain persists or increases, management then rises to  Step 3: opioids indicated for moderate to severe pain, administered with or without nonopioids or adjuvant medications. (this should be the very last)