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Adv MS Chapter 9
Pain
| Question | Answer |
|---|---|
| pain that results from tissue damage that generally abates as healing occurs; serves as a warning signal that something is wrong or needs attention | acute pain |
| a substance or medication added to an analgesic medication regimen to improve analgesia (synonym: co-analgesic agent) | adjuvant analgesic agent |
| a medication that binds to an opioid receptor mimicking the way endogenous substances provide analgesia | agonist |
| a type of opioid (e.g., nalbuphine and butorphanol) that binds to the kappa opioid receptor site acting as an agonist (capable of producing analgesia) and simultaneously to the mu opioid receptor site acting as an antagonist (reversing mu agonist effects) | agonist–antagonist |
| pain due to a stimulus that does not normally provoke pain, such as touch; typically experienced in the skin around areas affected by nerve injury and commonly seen with many neuropathic pain syndromes | allodynia |
| a medication that competes with agonists for opioid receptor binding sites; can displace agonists, thereby inhibiting their action | antagonist |
| a transitory increase in pain that occurs in the context of otherwise controlled persistent pain | breakthrough pain |
| an analgesic dose above which further dose increments produce no change in effect | ceiling effect |
| the abnormal hyperexcitability of central neurons in the spinal cord, which results from complex changes induced by the incoming afferent barrages of nociceptors and results in an increased nociceptive neuron response | central sensitization |
| chronic or persistent pain: pain that may or may not be time limited but that persists beyond the usual course/time of tissue healing | chronic or persistent pain |
| one of many medications that can either improve the effectiveness of another analgesic agent or independently have analgesic action (synonym: adjuvant analgesic agent) | co-analgesic agent |
| the pain rating identified by the individual patient above which the patient experiences interference with function and quality of life (e.g., activities the patient needs or wishes to perform) | comfort-function goal |
| the extent to which a medication or another treatment “works” and can produce the intended effect—analgesia in this context | efficacy |
| time it takes for the plasma concentration (amount of medication in the body) to be reduced by 50% (after starting a medication, or increasing its dose; four to five half-lives are required to approach a steady-state level in the blood | half-life |
| a substance or medication that is readily absorbed in aqueous solution | hydrophilic |
| hyperalgesia: an increasingly intense experience of pain resulting from a noxious stimulus | hyperalgesia |
| “within the spine”; refers to the spaces or potential spaces surrounding the spinal cord into which medications can be given | intraspinal |
| a substance or medication that is readily absorbed in fatty tissues | lipophilic |
| the product of biochemical reactions during medication metabolism | metabolite |
| any opioid that binds to the mu opioid receptor subtype and produces analgesic effects (e.g., morphine); used interchangeably with the terms full agonist, pure agonist, and morphinelike medication | mu agonist |
| the intentional, concurrent use of more than one pharmacologic or nonpharmacologic intervention with different methods of action with the goal to achieve better analgesia while using lower doses of medications with fewer adverse effects | multimodal analgesia or multimodal pain management: |
| of the central nervous system | neuraxial |
| pain caused by injury or dysfunction (lesion or disease) of one or more nerves of the peripheral or central nervous systems with resultant impaired processing of sensory input | neuropathic (pathophysiologic) pain |
| the ability of the peripheral and central nervous systems to change both structure and function as a result of noxious stimuli | neuroplasticity |
| pain that is sustained by ongoing activation of the sensory system that conducts the perception of noxious stimuli; implies the existence of damage to somatic or visceral tissues sufficient to activate the nociceptive system | nociceptive (physiologic) pain: |
| a type of primary afferent neuron that has the ability to respond to a noxious stimulus or to a stimulus that would be noxious if prolonged | nociceptor |
| refers to analgesic medications that include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) | nonopioid |
| an acronym for nonsteroidal anti-inflammatory drug (pronounced “en said”) | NSAID |
| refers to morphine and other natural, semisynthetic, and synthetic medications that relieve pain by binding to multiple types of opioid receptors; term is preferred to “narcotic” | opioid |
| occurs when a nonopioid or co-analgesic medication is prescribed in addition to an opioid, enabling the opioid dose to be lower without diminishing analgesic effects | opioid dose–sparing effect |
| a phenomenon in which exposure to an opioid induces increased sensitivity, or a lowered threshold, to the neural activity conducting pain perception; it is the “flip side” of tolerance | opioid-induced hyperalgesia |
| denotes a person who has not recently taken enough opioid on a regular enough basis to become tolerant to the opioid’s effects | opioid naïve |
| denotes a person who has taken opioids long enough at doses high enough to develop tolerance to many of the opioid’s effects, including analgesia and sedation | opioid tolerant |
| an unpleasant experience that is either emotional or sensory resulting from actual or possible damage to tissues and is uniquely experienced and described by each person | pain |
| a key peripheral mechanism of neuropathic pain that occurs when there are changes in the number and location of ion channels; in particular, sodium channels abnormally accumulate in injured nociceptors, | peripheral sensitization |
| the body’s normal response to administration of an opioid for 2 or more weeks; withdrawal symptoms may occur if an opioid is abruptly stopped or an antagonist is given | physical dependence |
| any medication or procedure, including surgery, that produces an effect in a patient because of its implicit or explicit intent and not because of its specific physical or chemical properties | placebo |
| pre-injury pain treatments (e.g., preoperative epidural analgesia and preincision local anesthetic infiltration) to prevent the development of peripheral and central sensitization of pain | preemptive analgesic agents |
| nonresponsive or resistant to therapeutic interventions such as analgesic agents | refractory |
| problematic use of substances such as opioids, benzodiazepines, or alcohol based on identification of at least two of the diagnostic criteria listed by the American Psychiatric Association. | substance use disorder (SUD) |
| upward or downward adjustment of the amount (dose) of an analgesic agent | titration |
| a normal physiologic process characterized by decreasing effects of a medication at its previous dose, or the need for a higher dose of medication to maintain an effect | tolerance |
| result of abrupt cessation or rapid decrease in dose of a substance upon which one is physically dependent. It is not necessarily indicative of substance use disorder | withdrawal |
Created by:
mcnabb
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