Question

a client being treated with imipramine, an anti - depressant for chronic cancer pain asks the nurse, \what is the reason for the anti - depressant medication?\ which explanation should the nurse provide the client?
a increases pain threshold by stimulating opiate receptors in the cns to release of endogenous endorphins
b increases pain tolerance through relief of depression by increasing the amounts of norepinephrine in the brain
c decreases perception of pain by blocking opiate receptors in the brain and descending inhibitory control
d decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses

Explanation:

Imipramine is a tricyclic antidepressant. Its mechanism for pain (especially chronic pain like cancer pain) involves altering the activity of neurotransmitters like serotonin and norepinephrine at nerve synapses, which helps decrease pain impulse transmission. Option A is incorrect as imipramine doesn't act on opiate receptors to release endorphins (that's more like opioids). Option B: While it relieves depression, the pain mechanism isn't just about increasing norepinephrine for pain tolerance via depression relief. Option C: It doesn't block opiate receptors. Option D correctly describes its mechanism—altering serotonin and norepinephrine activity at synapses to reduce pain impulse transmission.

Answer:

D. Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses