University of Central Florida NGR 5141 - Module 11 QUESTIONS AND ANSWERS. LATEST 2023

1. Mr. Bowers has a temperature of 101° F. His physician chooses not to treat the temperature unless it rises above 101.5° F. Why? Fever production is a response by the body to infectious processes. The elevated temperature kills many microorganisms and has adverse effects on the growth and replication of others. A higher body temperature also reduces levels of iron, zinc, and copper which the body needs for bacterial replication. Since fever is a beneficial response to infection, suppressing it with antipyrogenic medications should should be done if the fever is high enough to produce serious side effects such as nerve damage or convulsion. 2. In pain management, what is the physiologic rationale for the use of the following? A) Morphine via a patient controlled mechanism Neurohormones act as neurotransmitters by binding to one or more G-protein-coupled opioid receptors. Each of the three kinds of receptors (mu, kappa, delta) binds differently with various types of opioids. Agonist activity at the opioid receptors by endogenous opioids inhibits the release of excitatory neurotransmitters such as substance P in the dorsal horn or in other areas of the brain such as the PAG or rostral ventromedial nuclei in the brainstem. Opioids, such as morphine which could be used via a patient controlled mechanism, release adrenergic and serotonergic descending pathways from GABAergic inhibition and decrease pain. B) When you hit your elbow at the "funny bone" - why does rubbing it help the pain? Rubbing the area that has been hit possibly helps the pain due to segmental inhibition. This is elicited by activity in large-diameter cutaneous afferent fibers at the dermatome level which can be activated naturally by innocuous mechanical stimuli. It has been demonstrated that stimulation of a group of large, fast, heavily myelinated A-beta fibers can close the pain gates through an inhibitory interneuron. These afferent A-beta fibers carry non-noxious low-threshold mechanical information gained by touch, vibration, and pressure. C) anti-inflammatory agent Indirect excitation occurs through the release of inflammatory mediators after the tissue is injured. The injured tissue results in inflammation and the release of prostaglandins such as PGE2 and PGI2, TNF-alpha, nitric oxide bradykinins, and histamine. The activity within the nociceptors causes them to release peptides and neurotransmitters such as substance P, neurokinin A, calcitonin gene-related peptide, and adenosine triphosphate, which all promote the spread of