Pain Management & Analgesic Pharmacology – Lecture Review

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Seventy-five vocabulary flashcards summarizing key pharmacological terms, physiology concepts, drug facts, safety alerts, and nursing considerations from the lecture on pain management and analgesic therapy.

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75 Terms

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Opioid

A centrally acting analgesic that suppresses pain perception in the brain and spinal cord.

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Non-opioid

Analgesic that works in the peripheral nervous system, e.g., NSAIDs or acetaminophen.

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Central Nervous System (CNS)

Brain and spinal cord; primary target of opioid drugs.

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Peripheral Nervous System (PNS)

Nerves outside the brain and spinal cord; target of most non-opioids.

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Comfort Goal

The individualized pain-relief level a clinician aims to achieve for each patient.

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Acetaminophen (Tylenol)

Common non-opioid analgesic and antipyretic metabolized in the liver.

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Tylenol Maximum 24-Hour Dose

No more than 4,000 mg total—or 1,000 mg per dose—in 24 hours.

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Black Box Warning

FDA’s strongest safety alert; Tylenol carries one regarding liver toxicity.

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Percocet

Combination of oxycodone and acetaminophen; counts toward the daily Tylenol limit.

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Liver Metabolism

Process by which the liver chemically alters drugs; key for acetaminophen clearance.

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ALT (Alanine Aminotransferase)

Liver enzyme; elevated levels may signal hepatic injury.

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AST (Aspartate Aminotransferase)

Another liver enzyme used to assess hepatic function.

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GGTP (GGT)

Gamma-glutamyl transferase; enzyme often elevated in liver damage.

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Amylase

Digestive enzyme; sometimes monitored with other abdominal labs.

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Lipase

Pancreatic enzyme; rises with pancreatic or abdominal pathology.

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Jaundice

Yellowing of skin/eyes indicating possible liver dysfunction.

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NSAID

Non-steroidal anti-inflammatory drug that blocks COX enzymes to reduce pain and inflammation.

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Ketorolac (Toradol)

Potent injectable NSAID commonly used for short-term post-operative pain.

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COX-1 Inhibitor

Drug that blocks cyclooxygenase-1, affecting gastric and platelet functions.

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COX-2 Inhibitor

Drug that selectively blocks cyclooxygenase-2 to reduce inflammation with fewer GI effects.

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Nociceptive Pain

Pain from tissue injury or inflammation, e.g., post-surgical incision.

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Neuropathic Pain

Pain resulting from nerve damage or dysfunction.

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Acute Pain

Short-term pain (usually <3–6 months) that decreases as healing occurs.

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Chronic Pain

Persistent pain lasting ≥3–6 months, often requiring around-the-clock therapy.

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PCA Pump

Patient-controlled analgesia device that delivers small, self-administered opioid doses.

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Peak-and-Valley Effect

Fluctuating drug levels seen with intermittent dosing rather than continuous infusion.

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Tolerance

Physiologic adaptation requiring higher doses to achieve the same effect.

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Breakthrough Pain

Transient flare of pain despite baseline analgesia.

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Immediate-Release Drug

Formulation designed for rapid onset and short duration of analgesia.

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Sustained-Release Drug

Preparation that releases medication slowly for prolonged effect.

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Transdermal Patch

Drug-impregnated adhesive delivering medication through the skin over time.

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Lidocaine Patch

12-hours-on/12-hours-off topical anesthetic patch for localized pain.

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Fentanyl Patch

Potent opioid patch changed every 72 hours; requires controlled disposal.

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Controlled Substance

Drug regulated for potential abuse, e.g., fentanyl or morphine.

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IV Push

Rapid intravenous injection of medication over seconds to minutes.

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Standing Order

Pre-authorized routine medication order, often re-evaluated every 24 hours.

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Hydration with Tylenol

Adequate fluids aid renal excretion of acetaminophen metabolites.

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Hepatotoxicity

Liver damage potentially caused by acetaminophen overdose.

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Kidney Excretion

Renal elimination pathway for many drugs, including Tylenol metabolites.

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Epidural Analgesia

Continuous or intermittent drug delivery into the epidural space for pain control.

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Intraspinal Delivery

Administration of medication within spinal spaces (epidural or intrathecal).

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Bupivacaine

Long-acting local anesthetic often combined with opioids in epidurals.

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Fentanyl (Epidural Mixture)

Potent opioid (≈100× morphine) used in epidural infusions.

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Indwelling Urinary Catheter (Foley)

Tube placed in bladder; often justified during epidural therapy to manage retention.

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Straight Catheterization

Single-use catheter insertion to drain bladder and then remove.

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Functional Bladder Capacity

Typical urge to void occurs around 250-300 mL; nurses may cath at ≥500 mL per protocol.

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Bladder Scanner

Ultrasound device estimating bladder volume non-invasively.

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Peripheral Nerve Catheter

Catheter placed near a specific nerve to deliver continuous local anesthetic.

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Non-pharmacological Pain Relief

Techniques such as ice, elevation, massage, distraction, or imagery.

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Imagery

Guided mental visualization used to reduce pain perception.

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Repositioning

Changing body posture to alleviate discomfort.

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Massage Therapy

Manual manipulation of soft tissues to relieve pain and tension.

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Pain Scale

Standardized tool (e.g., 0–10 numeric) for assessing pain intensity.

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Therapeutic Effect

Desired clinical outcome of a medication, such as adequate pain relief.

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Adverse Reaction

Unintended, harmful effect occurring at normal drug doses.

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Drug Interaction

Alteration of drug effect when taken with another substance.

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Opioid-Benzodiazepine Combination Risk

Concurrent use can cause additive CNS depression leading to respiratory compromise.

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Opioid Itching

Pruritus commonly triggered by drugs like fentanyl or morphine.

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IV Tylenol Dose Size

Standard IV acetaminophen doses are 650 mg or 1,000 mg.

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Milligram Limit per Dose

Single acetaminophen doses should not exceed 1,000 mg.

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Oral Tylenol Strengths

Tablets typically available as 325 mg (regular) or 500 mg (extra strength).

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Anti-inflammatory Response

Physiologic process reducing swelling and pain after tissue injury.

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Tissue Injury

Damage to body tissues initiating nociceptive pain pathways.

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Inflammation

Localized protective response marked by redness, heat, swelling, and pain.

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Patient Teaching

Education on medication use, side effects, and safety measures.

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Continuous Infusion

Steady drug delivery, e.g., with epidural or PCA basal rate.

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PRN Dosing

Medication given as needed for symptoms like pain.

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On-Q Pump

Portable device that delivers local anesthetic continuously to surgical sites.

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Whipple Procedure

Extensive pancreatic surgery often requiring aggressive pain control.

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Ketamine

NMDA-receptor antagonist sometimes combined with opioids for severe pain.

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Breakthrough Dose

Extra dose ordered to treat episodic pain spikes in chronic-pain patients.

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Respiratory Rate Increase in Pain

Tachypnea commonly accompanies acute pain episodes.

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Blood Pressure Changes in Pain

Acute pain often elevates blood pressure; chronic pain may normalize values.

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Heart Rate Changes in Pain

Pain can trigger tachycardia via sympathetic stimulation.

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Comfort Measures (Ice, Elevation, Distraction)

Simple, low-risk strategies used before or alongside medication.