Pain Management & Medication Side-Effects – Key Vocabulary

Vocabulary flashcards summarizing key terms, medications, side-effects, assessment tools, and non-pharmacologic measures discussed in the pain-management lecture.

Acute Pain

Short-term pain that usually results from tissue damage or surgery and decreases with healing.

Chronic Pain

Pain that persists or recurs for longer than three months and often requires scheduled medication.

Nociceptive Pain

Pain arising from actual or potential tissue damage (e.g., surgical incision, arthritis).

Neuropathic Pain

Pain caused by nerve damage or dysfunction (e.g., sciatica, shingles).

Numeric Pain Rating Scale

Patient rates pain on a 0–10 scale; 0 = no pain, 10 = worst imaginable.

"What’s Up?" Assessment

Mnemonic for pain questions: Where, How bad, What triggers, Severity, Useful data, Past experience.

Opioid

Class of analgesics (e.g., morphine, hydromorphone) that relieve moderate-to-severe pain but can cause sedation, constipation, and respiratory depression.

NSAID

Non-steroidal anti-inflammatory drug (e.g., ibuprofen, naproxen) used for mild-to-moderate pain and inflammation; take with food to reduce GI irritation.

COX-1/COX-2 Inhibitor

Mechanism of NSAIDs that decreases prostaglandin synthesis and inflammation.

Maximum Ibuprofen Dose

800 mg per single dose; do not exceed 3,200 mg in 24 h without provider approval.

Aspirin Baby Dose

81 mg daily, commonly used for cardioprotection; risk of bleeding increases with additional NSAIDs.

Acetaminophen (Tylenol)

Analgesic/antipyretic metabolized by the liver; monitor AST/ALT, limit to ≤4 g per day.

Percocet

Combination of oxycodone and acetaminophen; count total daily acetaminophen intake.

Hydromorphone (Dilaudid)

Potent opioid; monitor closely for rapid onset of sedation and respiratory depression.

Fentanyl

Highly potent synthetic opioid; can produce pruritus (itching) and profound sedation.

Naloxone (Narcan)

Opioid antagonist given for unresponsiveness or respiratory rate <8/min with shallow breaths.

Sternum Rub

Painful stimulus used to assess arousability in an over-sedated patient.

Sedation Scale

Continuum from Alert → Drowsy → Lethargic → Stuporous → Obtunded → Coma.

Alert

Awake, oriented, and able to converse appropriately.

Drowsy

Lightly sedated; easily aroused by voice, may drift off during conversation.

Lethargic

Moderate sedation; aroused to voice but quickly falls back asleep.

Stuporous

Arouses only to vigorous tactile or painful stimuli; high danger for respiratory depression.

Obtunded

Minimal or no response to painful stimuli; precursor to coma.

Respiratory Depression

Slow, shallow breathing (≤8/min) often due to opioid overdose; treat with naloxone.

Constipation (Opioid-Induced)

Decreased bowel motility from opioids; manage with fiber, fluids, ambulation, stimulant laxatives.

Pruritus

Itching frequently associated with opioids, especially fentanyl; treat with hydration, skin moisturizers, or antihistamines if needed.

Dry Mouth

Common opioid side-effect; relieve with ice chips, mouth swabs, or sugar-free candies.

Hypotension

Drop in blood pressure that may accompany opioids; monitor vitals and patient dizziness.

Nausea/Vomiting

Frequent opioid adverse effect; non-drug measures (ginger ale, crackers) or antiemetics (e.g., prochlorperazine) may be needed.

Physical Dependence

Physiologic adaptation to opioids; abrupt cessation causes withdrawal symptoms.

Withdrawal Symptoms

Tremors, sweating, tachycardia, irritability occurring when long-term opioids or alcohol are stopped suddenly.

Patient-Controlled Analgesia (PCA)

Pump that allows patient to self-administer preset opioid doses; only the patient should push the button.

Scheduled vs PRN Dosing

Chronic pain requires around-the-clock (scheduled) dosing; PRN is inadequate alone.

Platelet Count

150,000–400,000 /µL normal; low levels increase bleeding risk with NSAIDs or aspirin.

Hemoglobin

Males ~13–18 g/dL, females ~12–17 g/dL; drop may indicate bleeding.

Hematocrit

Males 40–55 %, females 35–55 %; correlates with hemoglobin for blood-loss assessment.

AST/ALT

Liver enzymes monitored with high or chronic acetaminophen use.

Continuous Passive Motion (CPM)

Machine that gently moves a post-op joint (e.g., knee) to prevent stiffness and improve circulation.

Elevation & Ice

Orthopedic post-op measures to reduce swelling and burning pain.

TENS Unit

Transcutaneous electrical nerve stimulation device for neuropathic or muscle pain relief.

Fiber-Rich Foods

Apples, oatmeal, bran used to prevent opioid-induced constipation.

Adequate Hydration

Encouraging fluids (≈2 L/day) to support bowel function and reduce dryness.

Nonpharmacologic Interventions

Techniques such as heat/cold, massage, relaxation, music, or acupuncture to complement medication.

Swimming

Low-impact exercise recommended to strengthen muscles and relieve chronic low-back pain.

Combination Drug Interaction

Avoid taking two NSAIDs or mixing benzodiazepines with opioids due to additive sedation.

Safe Disposal of Opioids

Unused opioids should be flushed, locked, or taken to police drop boxes to prevent diversion.

Scheduled Laxative Plan

Standing order (e.g., Senna, milk of magnesia) begun when opioids are initiated, not PRN only.