ANALGESICS
Defining pain: * * PAIN: an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage * NOCICEPTIVE: activation of normal pain fibres in response to a noxious stimulus (e.g. injury, disease, inflammation); may be somatic (e.g. involving superficial structures such as skin and muscle) or visceral (e.g. involving deeper organs such as liver, pancreas) * NEUROPATHIC: injury or disease affecting the peripheral (e.g. diabetic neuropathy, phantom limb) or central (e.g. spinal cord injury, post stroke) nervous system or both (e.g. postherpetic neuralgia) * MIXED NOCICEPTIVE/NEUROPATHIC: e.g. cancer some cancer-related pain * BREAKTHROUGH PAIN: occurs between regular doses of an analgesic and reflects an increase in the pain level beyond the control of the baseline analgesia. This may just be an occasional natural fluctuation in pain or, if frequent, reflect inadequate baseline analgesia or management * INCIDENT PAIN: occurs with, or is exacerbated by, physical activity or an event such as a wound dressing. Inadequate stabilisation of a fracture or cough can also cause incident pain
Classification of pain: | Nociceptive - superficial somatic | Nociceptive – deep somatic | Nociceptive – visceral | Neuropathic | Origin of stimulus | Skin, subcutaneous tissue, mucous of mouth, nose, sinuses, urethra, anus | Bones, joints, muscles, tendons, ligaments, superficial lymph nodes, organ capsules an mesothelial membranes (pleura and peritoneum) | Solid or hollow organs, deep tumour masses, deep lymph nodes | Damage to nociceptive pathways | Description | Hot, sharp, stinging | Dull, aching, throbbing | Dull, deep, gnawing, cramping, colicky, pressure tightness | Dysaesthesia (e.g. pins and needles, tingling, burning, stinging, lancinating/shooting,