Seminar - Pharmacology and analgesics

• What is the World Health Organization’s approach to pain control called?

  The analgesic ladder
• Why is it important for nurses to understand pain physiology?

  It facilitates better decision making in pain management
• What are the consequences of unrelieved pain for individuals?

  Functional, cognitive, emotional, and societal consequences
• What are the key components of pharmacological approaches to pain management?

  • Comprehensive, person-centred approach
  • Involves non-opioid and opioid analgesics
  • Includes adjuvants
  • Regular dosing and review
  • Adapting treatment to the individual
• What is the first step in the WHO analgesic ladder?

  Non-opioid analgesics
• What should be done if adequate pain control is not achieved with non-opioids?

  Move to a weak opioid like codeine
• What are examples of non-opioid analgesics?

  Paracetamol and NSAIDs
• How do NSAIDs work to reduce pain?

  They inhibit the production of prostaglandins
• What is the role of prostaglandins in the inflammatory process?

  They are inflammatory mediators produced by COX enzymes
• What are some common side effects of NSAIDs?

  Nausea, vomiting, and abdominal pain
• What is a common contraindication for NSAIDs?

  People with gastric irritation
• What is the most commonly used NSAID?

  Ibuprofen
• How does ibuprofen work pharmacodynamically?

  It inhibits COX enzymes and prostaglandin synthesis
• What is the potency of codeine compared to morphine?

  Codeine has 1/10 the potency of morphine
• How does codeine reduce pain?

  By binding to opioid receptors in the spinal cord
• What are common side effects of opioid medications?

  Constipation, respiratory depression, and euphoria
• How is respiratory depression managed in opioid use?

  Monitor and administer naloxone if necessary
• What routes of administration are used for strong opioids?

  Oral, intravenous, subcutaneous, and transdermal
• What are adjuvant drugs in pain management?

  • Not typically used for pain
  • Helpful in combination with analgesics
  • Examples: antidepressants, corticosteroids
  • Specific purpose adjuvants for neuropathic pain
• How do tricyclic antidepressants (TCAs) help in pain management?

  By enhancing activity in descending inhibitory pathways
• What is the therapeutic dose of TCAs in pain management compared to depression treatment?

  Lower than doses used for depression
• What are the actions of analgesics and adjuvants at different points in pain pathways?

  • Analgesics reduce pain perception
  • Adjuvants enhance analgesic effects
  • Target different pain pathways
• What is the recommended first-line opioid in palliative care?

  Oral morphine
• What is the significance of mu receptors in opioid therapy?

  They are the most clinically significant opioid receptors
• How does the analgesic ladder guide pain management?

  It provides a structured approach to titration
• What should be done if analgesia is not achieved on the analgesic ladder?

  Progression up the ladder should occur
• What is the role of the periaqueductal grey region in pain modulation?

  It is the primary control centre for pain modulation
• What is the effect of opioid activation of mu-receptors in the gastrointestinal tract?

  It can cause constipation
• How do adjuvant analgesics differ from traditional analgesics?

  They are not primarily used for pain relief
• What is the purpose of using stool softeners with opioids?

  To manage constipation side effects
• What is the role of anti-emetics in opioid therapy?

  To manage nausea and vomiting
• How should pain management be adapted to individuals?

  By regularly reviewing and adjusting treatment