NSG 3105 Lecture Notes - Lecture 3: Substantia Gelatinosa Of Rolando, Spinothalamic Tract, Chronic Pain
10 Dec 2017
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Pg 17-40 and pg. 20-37 for pain and ulcer bpgs respectively. Endogenous opioids, serotonin, ne, gaba and neurotensin: treatments, use different agents because they work at different pain receptors, ex. Diabetic ulcers, herpes zoster, cancer chemo: cancer pain is combo or nociceptive and neuropathic, pain assessment, self-report and hx, behavioural observation and phys. Facial grimacing, rubbing: painad advanced dementia, neuropathic pain assessment via interview and exam, esas, bpi (brief pain inventory) self-reporting tool for acute, chronic pain in previous. 24 hrs: pain management, always know pts renal and hepatic function, multimodal approach recommended, balanced analgesia, acute pain, step 1 foundational drugs ex. Tramadol: weak serotonin and ne reuptake inhibition, mixed pain, se nausea and dizziness, step 3 strong opioids ex. Ketamine for nociceptive pain, neuropathic pain, post-op: cannabinoids (3rd line for neuropathic pain) For exam : definition of pain, opqrstu, understanding of opioid tolerance, harmful effect of unrelieved pain such as recovery impact, pain of older adults.
