Pain Therapy – Pharmacology Exam

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Pain Therapy – Pharmacology Exam

The key terms of Pharmacology Exam include, Pain, Therapy, Stimulation, Cognitive.


Cutaneous Stimulation

Application of heat and cold
Therapeutic touch
Vibration
Massage


Trancutaneous Electrical Stimulation

TENS
Cutaneous electrical stimulation
Usually initiated by PT
Empowers patient and gives some control


Physical Measures

Physical Therapy & Occupational Therapy
Goal to increase function, decrease pain
Methods:
Splints
Exercise
Heat and cold therapies


Pain

Number 1 reason to seek medical attention


Cognitive-Behavioral Therapy

Distraction
Very effective
Transient, best used with other measures
Guided imagery
Hypnosis
Modify environment
Meditation
Vibration
Music


Alternative Therapies

Acupuncture
Accupressure
Magnet therapy
Aromatherapy


PCA

PCA (Patient Controlled Analgesia)
Patient controls delivery of medication
Dosage preset
Advantages
Use less drug
Fewer side effects
Less time for nurse
Vital Signs, pain level,side effects monitored closely


Patient Controlled Analgesia
PCA

Settings: continuous, PCA or continuous with PCA
Example of an order:
Morphine Sulfate
Loading dose 2 mg
0.5mg continuous
PCA dose 1mg
Lockout 6 minutes
4 hour limit: 20mg


Benefits and Risks

Benefits
Empowers patients
Better control of pain
Reduces patient anxiety
Risks
Over sedation and respiratory depression
Drug administration set-up errors
Others besides patients pushing the button


Nursing Responsibilities

Monitor for adverse effects & follow protocols
VS & sedation levels every 2 hours
Assess for other side effects:
Urinary retention
Nausea
Itching
Consitpation
Educate patients on proper use and what to report
Obtain other pain therapies for patients who cannot administer PCA competently


Adjuvant drugs

Not true analgesics
Work alone or in combination to relieve pain
Enhance or potentate effectiveness of pain relief
Good with chronic pain and complex pain syndromes
Examples
Tricyclic antidepressants
Antiseizure medications
Antianxiety drugs
Corticosteroids


Topical and Local Anesthesia

Topical anesthesia
Local anesthetic infusion pumps: ON-Q Pump


Adjuvant Drugs

Benefits:
Reduce need for opiods
Work better for some types of pain
Treat associated symptoms of depression and sleep disorders with chronic pain


Best Practices for Scheduling of Medication

Pre-medicate for painful procedures/activities
Around the clock dosing preferred
Assess minimum every 4 hours

Treat pain early for better effect
Breakthrough dosing for cancer pain
Follow BRN of CA guidelines


Nonpharmacological Interventions

Cognitive-Behavioral Measures
Alternative Medicine
Complementary Medicine


Cutaneous Stimulation

-Application of heat and cold
-Therapeutic touch
-Vibration
-Massage


Trancutaneous Electrical Stimulation

TENS
Cutaneous electrical stimulation
Usually initiated by PT
Empowers patient and gives some control


Physical Measures

Physical Therapy & Occupational Therapy
Goal to increase function, decrease pain
Methods:
Splints
Exercise
Heat and cold therapies


Pain

1 reason to seek medical attention


Cognitive-Behavioral Therapy

Distraction
Very effective
Transient, best used with other measures
Guided imagery
Hypnosis
Modify environment
Meditation
Vibration
Music


Alternative Therapies

Acupuncture
Accupressure
Magnet therapy
Aromatherapy


Pain Management In The Elderly Patient

Pain is prevalent in the elderly
At risk for under treatment
Don’t describe the pain as “pain” but may call it discomfort, or soreness
Tend to report less often
May view as sign of weakness or
something to be lived with
Don’t want to be a bother