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Causes people to try to remove the cause of the pain or damage
Tissue damage may be chemical (inflammation ie bradykinen, histamine and prostaglandins or physical (heat, cold or pressure)
Causes people to try to remove the cause of the pain or damage
Tissue damage may be chemical (inflammation ie bradykinen, histamine and prostaglandins or physical (heat, cold or pressure)
Receptors are activated
Message transmitted to dorsal horn
Meanwhile the brain contains powerful descendint pathways that modify pain receptor input (increases in epinephrine and serotonin interupt or inhibit pain transmission) At the thalamus pain sensation is not specific it is relayed to the cerbaral cortex for more specific analysis
What does endogenous mean?
The receptors are located in the CNS including ascending & decending pain pathways.  Together the receptors and peptides inhibit pain transmission.
Addiction is marked by abusive behavior
Define schedule 2
PO first pass metabolism requires that the doses are very high, metabolized in the liver Liver impairment may interfere with metabolism and kidney may interfere with excretion Generally small to moderate doses relieve constant dull pain moderate to large for intermittent sharp pain
Give smaller dose if effective
More effective at the onset of pain parentaerally
Chronic on regular schedule
Give before coughing and deepbreathing or dressings
Long term use may be for malignant disease
Table 6-1  Mu, Kappa, Delta Pg 73
After IV 10-20 minutes for respiratory depression and analgesia
Ineffective pain management…morphine is doc with severe pain
Nonceiling…no upperlimit don dosage for tolerance
May give non opiods with opioids in chrnic pain
Normal respiration?
Medication error page 79
Prostatic hypertrophy, the client already has a problem voiding
Table 6-1 pg 73
If antagonists have a shorter duration than opioids…what does this mean in terms of dosing?
Peak intensity 36-72 hours
May reduce dose gradually orMethadone to controle sx
If in hospital side rails up and call bell within reach
Approximately 4 % is a toxic metabolite normally inactivated by conjoining with glutathione and excreted in a in acute or chroni or overdose glutathione may be depleted causing liver damage or fatal necrosis.  ETOH amplifies the effect
May do lavage or syrup of ipecac
Prostaglandins are chemical mediators that help regulated cell functions and participate in the inflammatory response to injury
Non selective…stomach upset
REFER to salicylism pa