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PC707-module 5-Pain Questions And Answers
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PC707-module 5-Pain Questions And Answers What is neuropathic pain? - 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, trigemi...

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  • October 13, 2024
  • 46
  • 2024/2025
  • Exam (elaborations)
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  • pc707 module 5 pain questions and answers

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PC707-module 5-Pain Questions And
Answers

What is neuropathic pain? - 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? -chronic reoccurring headaches


-vasculitis




What is acute & chronic pain? Acute-sudden onset & short duration


Chronic-lasts 3-6 months or longer




What is the step-wise approach to pain management? -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.

, PC707-module 5-Pain Questions And
Answers
Key points to remember about pain management: -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? -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? -MU


-KAPPA

-Delta

-Sigma




What does the binding to MU receptors cause? What drugs bind primarily to these receptors?

-Analgesia*


-Respiratory depression*

, PC707-module 5-Pain Questions And
Answers
-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?

-Analgesia*


-Sedation*

-Ex: nalbuphine (Nubain) & butorphanol (Stadol)




What role do delta & sigma pain receptors play? -it is not exactly known


-cause dysphoria & hallucinations*




Why do drugs that bind to primarily MU receptors also cause sedation? -they also bind to

KAPPA receptors to some extent--which causes sedation*




Full opioid agonists: -bind to MU receptors in the brain


-produces endorphins which causes the euphoric feeling-which provides pain relief

, PC707-module 5-Pain Questions And
Answers
Partial opioid agonists: -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: -morphine, heroin, methadone, hydromorphone,

oxymorphone, meperidine




Examples of moderate opioid agonists: -codeine, oxycodone, hydrocodone, etc.




What are mixed opioid agonist-antagonists? -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

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