DPNP Glossary

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11-point Likert scale: numeric rating scale where 0 equals Â“no painÂ” and 10 equals Â“worst possible pain,Â” widely used in studies of neuropathic pain treatments, named for its developer, Rensis Likert
action potential: electrical nerve impulse
acute pain: pain of sudden onset that usually stems from an identifiable source, pain eventually ceases
adaptive pain: pain that protects an individual from injury and/or promotes healing following an injury
adjective rating scale: quantitative pain assessment tool that allows patients to rate both the quality and level of pain intensity by choosing a descriptor with an assigned numerical value
affective: pertaining to mood, emotion, feeling, sensibility, or mental state
afferent: carrying inward or toward the spinal cord and central nervous system
A fibers: myelinated afferent fibers, subgroups that carry pain sensations are A-beta (Aâ) and A-delta (Aä) fibers
Akathisia: psychomotor restlessness
alkaline phosphatase: enzyme present in the liver, kidneys, intestines, teeth, blood, and developing bone, that is important in absorption and metabolism of carbohydrates, proteins, and fats and in calcification of bone
allodynia: condition in which ordinarily non-painful stimuli evoke pain
ALT: alanine aminotransferase, a blood test that measures enzyme useful in diagnosis of viral hepatitis and myocardial infarction
analgesia: pain relief
Arizona Sexual Experience Scale (ASEX): structured, five-question scale addressing sexual function, developed by thought leaders
Arrhythmia: irregularity of the heartbeat
ascending pain pathways: set of neurons that convey pain signals from peripheral receptors to higher levels of the central nervous system
AST: aspartate aminotransferase, a blood test that measures enzyme useful in diagnosing viral hepatitis and myocardial infarction
ataxia: inability to coordinate voluntary bodily movement
atonic bladder: urinary bladder with absence of muscle tone
autonomic: division of the nervous system that controls involuntary body functions
bradykinin: inflammatory substance released from damaged tissues as a pain signal, may also serve as a neurotransmitter
caffeine: central nervous system stimulant, found in coffee, tea, cola beverages, and chocolate
central sensitization: re-wiring of the central nervous system resulting from chronic pain
cerebral cortex: outer layer of neurons in the brain, integrates higher mental functions, general movement, organ functions, perception, and behavioral reactions
C-fiber: small-diameter, unmyelinated nerve fibers that transmit longlasting, deep, burning pain sensations
chronic pain: pain persisting >1 month beyond the resolution of an acute tissue injury, pain persisting or recurring for >3 months, or pain associated with tissue injury that is expected to continue or progress
cold hyperalgesia: exaggerated response in which cold thermal stimuli are perceived as pain
CPK: creatine phosphokinase, elevated levels in blood usually indicate injury or stress to heart, brain, and/or skeletal muscle
creatinine clearance (Clcr): test used to assess kidney function
cytochrome P450 (CYP) enzymes: group of liver enzymes important in metabolizing substances normally present in the body (eg, steroids, fat-soluble vitamins) and in detoxifying numerous environmental pollutants (eg, carcinogens present in tobacco smoke)
descending pain pathways: processes by which the brain modulates the perception of pain using chemical substances and nerve impulses that travel down to the cells in the spinal cord to counteract pain messages sent up by pain receptors in the periphery
desipramine: tricyclic antidepressant (TCA)
diabetic neuropathy (DN): group of peripheral nerve disorders associated with long-standing diabetes mellitus, may affect autonomic (involuntary), sensory, and motor nerves
distal symmetric polyneuropathy: damage involving peripheral sensory and/or motor nerves, may involve any or all types of afferent nerve fibers
distal symmetrical sensorimotor polyneuropathy: form of nerve damage involving multiple peripheral nerves that results in decreased movement and sensation, deficits occur on both sides of the body and progress from the extremities toward the
diuresis: increased production of urine
dorsal horn (DH): portion of the gray matter of the spinal cord that contains cell processes of sensory nerves and specialized nerve cells that transmit messages between neurons carrying information to and from the central nervous system
dysmotility: abnormal movement
dysthymia: chronic mood disorder characterized by depression
emesis: vomiting
endogenous opioid system: pain-modulation system controlled by the brain that involves natural substances that mimic the effects of opiate drugs (eg, morphine) and control pain
endorphins: group of naturally occurring neurochemicals in the brain that have pain-relieving properties
end-stage renal disease (ESRD): kidney disease that has progressed to the point at which the kidney is so badly damaged or scarred that hemodialysis or transplantation is required for patient survival
enkephalin: endorphin with opiate qualities found in the brain and spinal cord
enteric-coated: refers to drug coating that combats the effects of stomach acids, which can interact with or destroy certain drugs, allows the drug to be absorbed from the intestinal tract (is delayed-release)
entrapment syndromes: damage caused by direct pressure to a peripheral nerve such as repeated undetected trauma, progressive, examples include tarsal tunnel and carpal tunnel syndromes
exchange transfusion: procedure that involves the incremental removal of the patientÂ’s blood and replacement with fresh donor blood or plasma
fibromyalgia: common condition characterized by widespread pain in joints, muscle tendons, and other soft tissues
gamma-aminobutyric acid (GABA): major inhibitory neurotransmitter of the nervous system
gastric lavage: washing out the stomach with sterile water or a salt-water solution, removes undissolved and partially dissolved tablets/capsules
gastroparesis: form of nerve damage that affects the stomach, food is not digested properly and does not move through the stomach in a normal way, often results in vomiting, nausea, or bloating
glutamate: major excitatory neurotransmitter in the central nervous system, plays a vital role in the mediation of painful stimuli via its
H2 antagonist: agent that opposes the action of histamine, used to treat allergies, hives, and other local and systemic allergic reactions, examples include Axid, Pepcid, and Zantac
hemoglobin A1c (HbA1c): blood test providing information about an individualÂ’s average blood glucose level for the prior 3 months, used to evaluate overall blood glucose control, normal value in non-diabetic is 4% to 6%
hemoperfusion: process that removes substances from the blood through the dialysis membrane by using a charcoal or resin artificial kidney
hepatic insufficiency: condition in which the liver cannot carry out its normal biochemical functions
hyperalgesia: extreme sensitivity to painful stimuli
hyperosmolar nonketotic coma: complication of Type 2 diabetes characterized by decreased consciousness, extreme dehydration, and extremely high blood glucose levels without the presence of ketones
hyperthermia: much higher than normal body temperature
last observation carried forward (LOCF): statistical method used in clinical trials in which values or outcome measures for patients who do not complete a study are carried forward into subsequent analyses
limbic system: collective term for a heterogeneous group of brain neuronal structures at or near the edge (limbus) of the inner wall of the cerebrum, thought to work together to affect emotions and mood, also exerts an important influence on the endocrine and autonomic motor systems
locus ceruleus: nucleus (group of cells) in the midbrain whose cells use norepinephrine as their neurotransmitter in the descending pain pathways, also has projections to the cerebral cortex and limbic system
lorazepam: benzodiazepine tranquilizer, prescribed in the treatment of anxiety, nervous tension, and insomnia
maladaptive pain: pain caused by pathologic processes occurring in the nervous system, ie, pain as a Â“diseaseÂ”
McGill Pain Questionnaire (MPQ): pain assessment tool frequently used to measure the quality and intensity of chronic pain, 78 adjectives with an assigned value of 1 to 5 are employed
Michigan Neuropathy Screening Instrument (MNSI): questionnaire used by health care professionals to screen for distal
microvascular insufficiency: reduced blood flow and oxygen delivery in small blood vessels, including those that supply the peripheral nerves
mixed-effects model repeated measures (MMRM): statistical method used in clinical trials that uses a patientÂ’s data up
modulate: process of regulating or attenuating stimuli
mononeuritis: damage involving isolated peripheral nerves, usually single nerve, but may be multifocal, not progressive and resolves spontaneously
mu-opioid receptor: one of several classes of opiate receptors in the central nervous system, activation results in analgesia and sedation
mydriasis: dilation of the pupil of the eye
myelin: layer made up of protein and lipids that forms a sheath around nerves, allows faster and energetically efficient transmission of
myoclonus: spasm of a muscle or group of muscles
napthol: any one of a series of hydroxyl derivatives of naphthalene, analogous to phenol
narrow-angle glaucoma: abnormal condition of elevated pressure within the eye caused by obstruction of the outflow of aqueous humor when the pupil dilates markedly in an eye with a narrow angle between the iris and cornea
neural plasticity: ability of the brain and/or certain parts of the nervous system to adapt to new conditions, such as an injury
neuropathic pain: pain caused by injury to sensory nerves or damage to the central nervous system, in which pain signals are generated and transmitted to the brain in the absence of noxious stimuli
N-methyl-D-aspartate (NMDA) receptors: receptors located in the central and peripheral nervous systems,
nociceptive pain: pain caused by activity of neural pathways in response to potentially tissue-damaging stimuli
nociceptors: nerve cells that fire in response to stretching or compressing of nerve fibers and to certain chemicals
noxious: anything injurious to physical or mental health, including chemical, mechanical, or thermal stimuli
nucleus raphe magnus: nucleus (group of cells) in the midbrain whose cells use serotonin as their neurotransmitter in the descending pain pathways
numeric rating scale: quantitative pain assessment tool that allows patients to rank pain according to a numeric value (eg, Â“0Â” represents no pain)
open-label: study in which the investigators and patients know which treatment each patient is receiving
periphery: outside or superficial portions of the body, the surface
phenothiazines: antipsychotic agents
post-herpetic neuralgia: pain associated with herpes zoster (shingles) that continues long after the rash has resolved, causes much suffering and disability
postural Hypotension: drop in blood pressure that occurs upon standing
PR interval: in the ECG, the time elapsing between the beginning of the P wave and the beginning of the next QRS interval
prefrontal cortex: part of the cerebral cortex at the very front of the brain, involved with functions such as short-term memory, learning, attention, awareness, and emotion
Pregnancy Category C: one of five possible categories for labeling a drug with regard to use in pregnant women, this category indicates either: (1) studies in animals have revealed adverse effects on the fetus and there are no controlled studies in women, or (2) studies in women and animals are not available, drugs in this category should be given only if the potential benefit justifies the risk to the fetus
prostaglandins: physiologically active substances present in many tissues, with inflammatory effects such as vasodilation, vasoconstriction, and stimulation of smooth muscle
proximal motor neuropathies: damage involving motor nerves, primarily affects elderly, starts with pain in thighs, hips, or buttocks followed by muscle weakness, begins on one side of the body, then spreads to both sides
QRS interval: in the ECG, the interval that denotes depolarization of the ventricles, between the beginning of the Q wave and the end of the S wave
QT interval: in the ECG, time from the Q wave to the end of the T wave corresponding to electrical systole (contraction of the heart)
rate-corrected QT interval (QTc): duration of the QT interval on the ECG, adjusted for the patientÂ’s heart rate, a prolonged QTc is associated with an increased risk of arrhythmia (irregular heartbeat) and sudden death
silent myocardial infarction: injury to heart muscle caused by decreased blood supply (usually a blocked artery) that occurs without symptoms or pain
somatic pain: most common type of nociceptive pain, results from activation of nociceptors in the skin, bone, or deep tissue
substance P: neurotransmitter thought to be the principal chemical mediator of pain impulses from the periphery
suicidality: suicidal ideation and behavior
systolic blood pressure: pressure in the blood vessels as the heart beats
temporal: pertaining to time
thalamus: cluster of nerve cells deep in the brain that serve as a center for the relay of sensory information (especially that involving pain and/or pleasure)
theophylline: agent used in bronchial asthma and other forms of chronic obstructive pulmonary disease
therapeutic index: difference between the minimum therapeutic concentration and minimum toxic concentration of a drug
titrated: dosage gradually increased until the desired result is achieved
transduction: process of detecting a stimulus and converting it to an impulse
transmission: series of events that conduct the pain impulse throughout the nervous system
treatment-emergent adverse events: adverse events that occurred for the first time or worsened with treatment, following baseline evaluation
trigeminal neuralgia: condition characterized by severe, shock-like or lancinating (tearing) facial pain that is recurrent but brief in duration
Type 1C antiarrhythmics: class of agents that prevent and/or treat abnormal heart rhythm, includes propafenone and flecainide
verbal pain intensity scale: pain assessment scale in which patients assess pain severity using a limited selection of descriptive terms
vincristine: cancer chemotherapy agent
visceral pain: pain resulting from noxious stimulation of nociceptors in smooth muscle tissue or organs
visual analog scale (VAS): quantitative pain assessment tool that allows patients to indicate the severity of their pain by placing a mark on a pain continuum ranging from Â“noneÂ” to Â“unbearableÂ”
warfarin: oral anticoagulant

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