Pain Management and Analgesia - Vocabulary Flashcards (Video Notes)

Vocabulary flashcards covering definitions, classifications, assessment tools, analgesic pharmacology, SUD concepts, and nursing care related to pain from the video notes.

Pain

The patient’s own description of their experience; considered whatever the patient says it is.

Acute Pain

Pain that results from tissue damage; usually short in duration and serves as a warning of injury.

Chronic Pain

Pain that persists beyond normal healing time; can be time-limited or lifelong (including cancer pain).

Noncancer Pain

Pain not caused by cancer; examples include peripheral neuropathy and back pain.

Breakthrough Pain

Acute pain episodes that occur on a background of chronic pain despite baseline analgesia.

Nociceptive Pain

Physiologic pain arising from tissue damage.

Neuropathic Pain

Pathophysiologic pain from damage to peripheral or central nervous system; may occur without tissue damage or inflammation.

Reflex Pain

Pain that may involve spinal cord reflex pathways with minimal supraspinal processing.

Pain Assessment Components

Self-report; location; intensity; quality; onset/duration; aggravating/relieving factors; effects on function/QoL; comfort function goal.

FLACC Scale

Pain assessment tool for young children: Face, Legs, Activity, Cry, Consolability.

PAINAD Scale

Pain Assessment in Advanced Dementia.

CPOT

Critical-Care Pain Observation Tool.

Multimodal Analgesia

Using multiple drugs from different classes to improve pain relief and reduce side effects.

PCA (Patient-Controlled Analgesia)

Analgesia method where the patient presses a button to deliver a preset opioid dose.

Opioids

Drugs that act on the central nervous system to inhibit ascending nociceptive pathways and provide analgesia.

Mu Opioid Agonists (Mu Agonists)

Opioids that activate μ receptors (e.g., morphine, hydromorphone, fentanyl, oxycodone, hydrocodone, methadone).

Agonist-Antagonist Opioids

Opioids with mixed actions such as buprenorphine, nalbuphine, and butorphanol.

Dual-Mechanism Analgesics

Drugs like tramadol and tapentadol that weakly activate mu receptors and block reuptake of serotonin and/or norepinephrine.

Opioids to Avoid

Codeine and meperidine (Demerol) due to limited efficacy or toxicity concerns.

Local Anesthetics (Analgesia)

Agents like lidocaine patches (e.g., 5% Lidoderm) that block nerve conduction in treated areas.

Anticonvulsants

Drugs such as gabapentin and pregabalin used as adjuvants for certain pain syndromes.

Antidepressants (Pain)

TCAs (desipramine, nortriptyline) and SNRIs (duloxetine,venlafaxine) used for neuropathic pain and mood modulation.

Ketamine

NMDA receptor antagonist used as an adjuvant for analgesia in certain scenarios.

Physical Dependence

Normal withdrawal symptoms that can occur with continued opioid use for 2 weeks or more.

Tolerance

Need for increasing opioid dose over time to achieve the same level of pain relief.

Substance Use Disorder (SUD)

Opioid addiction characterized by impaired control, compulsive use, continued use despite harm, and craving; influenced by genetic, psychosocial, and environmental factors.

Morphine

Widely used, potent opioid; can cause vasodilation; short-acting.

Fentanyl

Rapid-onset, short-duration opioid; often used IV for rapid analgesia; minimal hemodynamic effects.

Hydromorphone

Opioid with onset/duration between morphine and fentanyl.

Oxycodone

Oral opioid suitable for all types of pain.

Oxymorphone

Oral opioid that should be taken on an empty stomach (1 hour before or 2 hours after a meal).

Hydrocodone

Available only in combination with non-opioid analgesics.

Methadone

Oral opioid with a very long and highly variable half-life; often used in SUD treatment.

Codeine

Prodrug converted to morphine; 5–10% of people lack the enzyme to convert, risking inadequate effect or overdose in rapid metabolizers.

Meperidine (Demerol)

Opioid largely avoided/restricted due to neurotoxicity concerns.

Adverse Effects of Analgesics

Nausea/vomiting; constipation; pruritus; hypotension; sedation; respiratory depression.

Gerontologic Considerations

Older patients are more sensitive to CNS effects; start low, titrate slowly; higher risk of NSAID GI toxicity; acetaminophen for mild pain; consider opioid dose reduction (25–50%).

Natural Products in Pain Management

Herbs, botanicals, vitamins, and probiotics used as complementary approaches.

Mind and Body Practices

Nonpharmacologic therapies such as acupuncture, chiropractic, massage, yoga, tai chi.

Nursing Process Framework for Pain

Identify goals; establish nurse-patient relationship and teach; evaluate pain management strategies; address anxiety about pain.

Nursing Care for Pain

Integrate pharmacologic and nonpharmacologic strategies; set comfort/pain relief goals; plan for scheduled analgesia; prepare patient for painful procedures.