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