Understanding Pain: Pathways, Analgesics, Scales, and Adjuvant Therapy

This assignment delves into the multifaceted realm of pain management, beginning with an exploration of pain pathways, identifying the three neurons involved and their roles. It then differentiates and discusses the use of various analgesics, including anticonvulsants, antidepressants, paracetamol, and ibuprofen, for managing nerve, soft tissue, and organ injury pains, respectively, along with their mechanisms of action. The document also pinpoints opioid receptors as the primary targets for opioid analgesics and addresses contraindications and safe administration practices. Furthermore, it outlines adjuvant therapies for opioid-induced cluster symptoms, emphasizing the use of antidepressants and anxiolytics. Finally, the assignment underscores the purpose of pain scales and validated pain tools in assessing pain, particularly in children and the elderly, highlighting their role in guiding treatment and monitoring patient progress. The solution is supported by current research and APA 7th edition formatting.

Running Head: UNDERSTANDING PAIN 1
Understanding Pain
Name
Instructure

UNDERSTANDING PAIN 2
Understanding Pain
Identify pain pathways
In the pain pathways, three neurons are involved in signaling pain. First-order neurons are
mainly pseudo unipolar neurons with body cells in the ganglion root. They also have an axon
that divides into two different branches (Yam et al., 2018). Second-Order neurons are within the
Rexed laminae or in the cranial nerves of the brain system. Third-order neurons lie in the VPL
thalamus and project through the posterior limb of the capsule and terminate in the
somatosensory cortex.
Analgesics appropriate to manage 3 different types of pain
Anticonvulsants help to reduce pain in the nerves although it takes two to four weeks to be
effective. An antidepressant such as amitriptyline and doxepin are also effective in controlling
pain in the nerves. On the other hand, Paracetamol, ibuprofen is prescribed to patients with soft
tissue pains (Hung et al., 2018). Ibuprofen pain killers are also used to relieve organ injury pains.
Mechanisms of actions of these analgesics
Analgesics such as Paracetamol reduce pain intensity signals sent to the brain. Pain killers
prevent the release of prostaglandin chemicals that are sent to the brain to increase body pain.
Analgesics reduce intracellular Cyclic adenosine monophosphate that regulates the release of
nociceptive.
Targeted receptors for opioids

UNDERSTANDING PAIN 3
The main target for opioids is the Opioid receptors in the nerves. When the two binds, the
Opioid receptor reduces the release of GABA. By these, chemical messages from the brain to the
nerves is reduced and consequently relieving pain.
Contraindications and practice opioids administration
Some of the common contraindications of Opioids use is prescription abuse, where most
young people may abuse the drug. If the drug is not used cautiously by the patient with a seizure
disorder, their condition may worsen ("Opioid analgesics abuse", 2019). Physicians and
pharmacists should well advise their patients on medical adherence and following the set
prescriptions. The user should also avoid alcohol or any sleep medication to reduce risk.
Types of adjuvant therapy required in managing opioid-induced cluster symptoms
The patients that are depressed may be administered with an antidepressant which may be
effective to relieve stress (Mayerson & Julian, 2017). Besides, if the patient is anxious the
corticosteroids, anxiolytics and neurosurgical drugs may be effective.
Discuss the purpose of using a pain scale
Pain scales are will help measure the child's behavior and the pain history to asses the child's
pain. The pain scale enables the health practitioners to take better healthy measures that
inconsiderate of a child's behavior (Hejr, Alizadeh, Paymard & Khalili, 2017). The scale is also
useful as it detects the pains and one can begin diagnostic process among the aged, Health
practitioners can understand the cause of pain and what is the best treatment in consideration of
the age of the patient and, therefore, one can monitor the healing process of the patient.
.

UNDERSTANDING PAIN 4
References
Hejr, H., Alizadeh, Z., Paymard, A., & Khalili, A. (2017). A systematic review of the pain
assessment method in children. Annals of Tropical Medicine And Public Health, 10(4),
847. DOI: 10.4103/atmph.atmph_155_17
Hung, K., Graham, C., Lo, R., Leung, Y., Leung, L., & Man, S. et al. (2018). Oral paracetamol
and/or ibuprofen for treating pain after soft tissue injuries: Single-center double-blind,
randomized controlled clinical trial. PLOS ONE, 13(2), e0192043. DOI:
10.1371/journal.pone.0192043
Mayerson, E., & Julian, T. (2017). Acute Pain Management for Patients on Medication-Assisted
Treatment for Opioid-Use Disorder. Topics In Pain Management, 33(3), 1-10. DOI:
10.1097/01.tpm.0000525815.84692.6
Opioid analgesics abuse. (2019). Reactions Weekly, 1784(1), 201-201. DOI: 10.1007/s40278-
019-72920-z
Yam, M., Loh, Y., Tan, C., Khadijah Adam, S., Abdul Manan, N. and Basir, R. (2018). General
Pathways of Pain Sensation and the Major Neurotransmitters Involved in Pain
Regulation. International Journal of Molecular Sciences, 19(8),