Pain Management & Concepts Lecture

75 vocabulary flashcards covering key pain, addiction, and pharmacology terms from the lecture.

Addiction

Compulsive, persistent drug-seeking and use despite negative consequences.

Physical dependence

Physiologic adaptation that produces withdrawal symptoms when a drug is stopped abruptly.

Psychological dependence

Emotional or mental craving for a drug’s rewarding effects.

Tolerance

Need for progressively higher doses to attain the same pharmacologic effect.

Threshold

Point at which a stimulus is first experienced as painful.

High threshold

Requires a strong stimulus before pain is perceived.

Low threshold

Pain is felt with minimal stimulus and sooner in time.

Opioid

CNS-acting analgesic that binds to opioid receptors to relieve severe pain.

Controlled dangerous substance

Medication regulated by law because of abuse potential (e.g., opioids).

Pseudoaddiction

Drug-seeking behavior driven by unrelieved pain, not true substance abuse.

Pain assessment

Structured evaluation of pain location, intensity, quality, timing, and impact.

Nociception

Overall physiologic process of detecting and transmitting noxious stimuli.

Transduction

First nociceptive stage where tissue damage converts to electrical impulses.

Transmission

Movement of pain impulses along peripheral nerves to the spinal cord and brain.

Perception (pain)

Conscious awareness and interpretation of pain in the cortex.

Modulation

Processes that enhance or inhibit pain signals via endogenous chemicals.

Stimulus

Event such as injury, inflammation, or cramp that triggers pain pathways.

Pain stimulus

Specific noxious input that initiates transduction.

Sensitivity

Susceptibility of pain receptors to respond to a stimulus.

Acute pain

Short-term pain related to recent tissue injury; resolves as healing occurs.

Chronic pain

Persistent or recurrent pain lasting longer than 3 months.

Neuropathic pain

Pain caused by nerve injury or dysfunction, often burning or shooting.

Nociceptive pain

Pain from actual or threatened damage to non-neural tissue (e.g., incision).

Chronic malignant pain

Long-lasting pain associated with cancer or other progressive disease.

Chronic nonmalignant pain

Persistent pain not linked to active cancer, e.g., low-back pain.

Referred pain

Pain perceived at a site distant from its origin (e.g., MI arm pain).

Diabetic gastroparesis

Delayed stomach emptying in diabetes that may lead to long-term opioid use.

Sciatica

Radiating pain along the sciatic nerve, often from lumbar compression.

Carpal tunnel syndrome

Median nerve compression at wrist causing hand pain, numbness, tingling.

Phantom limb pain

Pain perceived in an amputated limb due to neural pathway memory.

Trigeminal neuralgia

Severe shock-like facial pain along trigeminal nerve branches.

Shingles (herpes zoster)

Viral reactivation causing acute burning neuropathic pain with dermatomal rash.

WHO analgesic ladder

Stepwise guideline starting with non-opioids and escalating for pain relief.

Non-opioid analgesic

First-line pain drug such as acetaminophen or an NSAID.

Morphine

Prototype opioid analgesic for moderate-to-severe pain.

Dilaudid (hydromorphone)

Potent opioid analgesic alternative to morphine.

Serotonin

Neurotransmitter affecting mood and modulating pain pathways.

Prostaglandins

Mediators released at injury that sensitize nociceptors and promote pain.

Bradykinin

Peptide that dilates vessels and contributes to pain, redness, swelling.

Substance P

Neurotransmitter that transmits and amplifies pain signals in CNS.

Endorphins

Endogenous opioids that naturally inhibit pain perception.

Vasodilation

Widening of blood vessels, lowering resistance and pressure.

Epinephrine

Fight-or-flight hormone that can heighten acute pain responses.

Norepinephrine

Neurotransmitter influencing arousal and pain modulation in CNS.

Acetylcholine

Neurotransmitter affecting autonomic responses during pain episodes.

Pain scale (0-10)

Numeric rating tool patients use to report pain intensity.

Clock-watching behavior

Early, repeated requests for medication typical of addiction.

Manipulation (in addiction)

Behavior strategies (e.g., multiple calls) to obtain more drugs.

Pain threshold vs tolerance

Threshold is when pain starts; tolerance is how much pain can be endured.

Pain perception

Individual cognitive and emotional appraisal of a pain signal.

Pain management

Comprehensive plan to assess, treat, and evaluate pain relief.

Pain modulation chemicals

Endogenous substances (endorphins, serotonin) that dampen pain.

Pain neurotransmitter

Chemical messenger like substance P involved in nociception.

Analgesic

Any drug or therapy whose primary purpose is pain relief.

Antidepressant

Medication class (e.g., SSRI, SNRI) also used for chronic neuropathic pain.

SSRI / SNRI

Drugs that block serotonin ± norepinephrine reuptake, boosting mood and analgesia.

NSAID

Non-steroidal anti-inflammatory drug that blocks prostaglandin synthesis to relieve pain.

Heating pad therapy

Local heat application that relaxes muscles and reduces discomfort.

Elevation (non-drug therapy)

Raising injured part to decrease swelling and pain.

Body language cues

Non-verbal signs (guarding, restlessness) indicating pain.

Facial expression cues

Grimacing, frowning, or wincing that signals discomfort.

Blood pressure changes in pain

Acute pain often triggers sympathetic rise in BP.

Pulse changes in pain

Heart rate typically increases during severe pain episodes.

Vasodilation effect on BP

Wider vessels lower blood pressure as pain subsides.

ST-segment elevation (MI)

ECG sign of heart muscle injury causing possible referred pain.

Nitroglycerin

Vasodilator used to relieve ischemic chest pain.

Chest-derived arm pain

Classic referred pain pattern during myocardial infarction.

Post-laparoscopic shoulder pain

Referred discomfort from CO₂ gas irritating the diaphragm after lap surgery.

Laparoscopic insufflation gas

Carbon dioxide introduced to expand abdomen; source of referred shoulder pain.

Gallbladder removal (cholecystectomy)

Surgery that can cause CO₂-related shoulder pain post-op.

Appendectomy pain expectations

Moderate acute pain that usually diminishes as tissue heals.

Bone cancer pain

Intense nociceptive pain originating from malignant bone lesions.

Osteoarthritis pain

Degenerative joint pain classified as chronic nociceptive discomfort.

Deep vein thrombosis (DVT)

Clot in deep vein causing swelling and possible aching or stabbing pain.

Pain neurotransmitter release

Liberation of chemicals (e.g., substance P, prostaglandins) after injury initiating nociception.