Central Nervous System Drugs PT 4

What percentage of cancer patients can have their pain relieved?

90%

What is a common issue with pain management in cancer patients?

Pain often goes unrelieved.

What is the process of pain management in cancer patients?

It involves repeated cycles of assessment, intervention, and reassessment.

What is breakthrough pain in cancer patients?

It is pain that occurs despite ongoing pain management, requiring additional relief measures.

What are the two major forms of pain experienced by cancer patients?

Nociceptive pain and neuropathic pain.

What is nociceptive pain?

Pain that results from injury to tissue, often ongoing.

What is neuropathic pain?

Pain that results from injury to peripheral nerves, characterized by burning, numbness, and tingling.

What are the three groups of analgesics used in cancer pain management?

Nonopioid analgesics, opioid analgesics, and adjuvant analgesics.

What are examples of nonopioid analgesics?

NSAIDs and acetaminophen.

What guides drug selection for pain management in cancer patients?

The WHO analgesic ladder.

How does the WHO analgesic ladder dictate pain management?

As pain intensity increases, treatment progresses from nonopioid analgesics to moderate opioids to powerful opioids.

When should opioids be administered to most cancer patients?

On a fixed schedule.

What should be included alongside medication for pain management?

Comfort measures and alternative interventions.

How are elderly patients' sensitivities to drugs compared to younger adults?

Elderly patients are more sensitive to drugs than younger adults due to a decline in hepatic metabolism and renal excretion.

What is a common issue regarding pain management in older adults?

Undertreatment in older adults is common due to a decline in circulation.

What risks do older adults face in pain management?

Older adults are at increased risk for adverse effects, side effects, and adverse drug interactions.

How is cancer pain management in children different from adults?

Management of cancer pain in children is more difficult, and verbalization of pain is reliable in children older than 4 years.

What should be observed in children under 4 years for pain assessment?

In children under 4 years, nonverbal cues and behavioral observations should be used to assess pain.

What is the purpose of Pain Management Standards from TJC?

To make pain relief an institutional priority and reduce the incidence of pain undertreatment.

What should you do first after administering pain medication?

Chart the medication and the vital signs at the time of administration.

When should you assess a patient after giving pain medication?

Within the hour after administering the medication.

What is migraine?

Migraine is a neurovascular disorder involving dilation and inflammation of intracranial arteries.

What are the two ways antimigraine drugs are used?

Antimigraine drugs are used in two ways: abortive and prophylactic.

What is the goal of abortive therapy for migraines?

The goal of abortive therapy is to eliminate headache pain and associated nausea and vomiting.

What is the goal of prophylactic therapy for migraines?

The goal of prophylactic therapy is to reduce the incidence and intensity of migraine attacks.

What are the two kinds of drugs for abortive therapy?

The two kinds of drugs for abortive therapy are non-specific analgesics and migraine specific drugs.

What are examples of non-specific analgesics used for migraines?

Aspirin-like drugs and opioids are examples of non-specific analgesics.

When are opioid analgesics used for migraines?

Opioid analgesics are reserved for severe migraine that has not responded to other drugs.

What are triptans used for?

Triptans are first-line drugs for abortive therapy of moderate to severe migraine.

How do triptans work?

Triptans activate 5-HT receptors, constricting intracranial blood vessels and suppressing the release of inflammatory neuropeptides.

In what forms are triptans available?

Triptans are available in oral forms, and sumatriptan is available in nasal spray or subcutaneous form.

What is a potential side effect of triptans?

Triptans can cause coronary artery vasospasm.

Who should avoid triptans?

Triptans are contraindicated in patients with prior myocardial infarction, ischemic heart disease, or uncontrolled hypertension.

What should triptans not be combined with?

Triptans should not be combined with one another, ergot derivatives, SSRIs, or SNRIs.

What is ergotamine used for?

Ergotamine is a second-line drug for abortive therapy for severe migraine.

What is a caution regarding the use of ergotamine?

Ergotamine should not be taken routinely due to the risk of physical dependence.

Is ergotamine safe during pregnancy?

No, ergotamine should not be taken during pregnancy.

Who should consider prophylactic therapy for migraines?

Those who suffer frequent attacks (two or more a month) should consider prophylactic therapy.

What are some drugs used for migraine prophylaxis?

Propranolol, Divalproex, Topiramate, and Tricyclic Antidepressants are used for migraine prophylaxis.

Which tricyclic antidepressant is used for migraine prophylaxis?

Amitriptyline (Elavil) is a tricyclic antidepressant used for migraine prophylaxis.

What medications are used for migraines associated with menses?

Estrogens and triptans are used for migraines associated with menses.

What are some drugs used for prophylaxis of headaches?

Calcium Channel blockers (verapamil), Botulinum toxin, Angiotensin-converting enzyme inhibitors, Angiotensin II receptor blockers.

What characterizes cluster headaches?

Severe throbbing unilateral pain in the orbital-temporal area, lasting 15 minutes to 2 hours.

How often do cluster headaches occur?

1 to 2 headaches per day for 2 to 3 months.

What is the first line drug for cluster headaches?

Verapamil.

What should be administered if a cluster headache occurs?

Oxygen and sumatriptan.

What is the most common type of headache?

Tension-type headaches.

What type of pain is associated with tension-type headaches?

Moderate, non-throbbing pain in a headband distribution.

How are tension-type headaches treated?

With nonopioid analgesics or NSAIDs.