Medical Glossary

Adjuvant analgesic: medicine which has a primary indication other than pain, but is analgesic in some painful conditions. This excludes medicines administered primarily to manage adverse effectsassociated with analgesics, such as laxatives and anti-emetics.
Adolescent: a person from 10 to 18 years of age.
Analgesic (medicine): medicine that relieves or reduces pain.
Anatomical Therapeutic Chemical (ATC) Code: classification system of medicines into differentgroups according to the organ or system on which they act and their chemical, pharmacological and therapeutic properties.
Breakthrough pain: temporary increase in the severity of pain over and above the pre-existingbaseline pain level.
Child: the narrow definition for children is from 1 to 9 years of age. However in these guidelines, theterm children is used in a larger sense to comprise neonates, infants and often adolescents.
Controlled medicines: medicines that contain controlled substances.
Controlled substances: the substances listed in the international drug control conventions.
Dependence syndrome: a cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use, and that typically include a strong desire to take the drug, difficulties incontrolling its use, persisting in its use despite harmful consequences, and a higher priority given to drug use than to other activities and obligations (ICD-10 definition).
Dispersible tablets (oral solid formulation): uncoated or film-coated tablets that can be dispersedin liquid for administration as a homogenous dispersion. They can be dissolved, dispersed or mixed withfood, in a small amount of water or breast milk prior to administration. They can be used in very young children (0–6 months), and require minimal manipulation from health-care providers and caregivers for administration, which minimizes the risk of errors.
End of dose pain: pain occurring when the blood level of the medicine falls below the minimal effective analgesic level towards the end of a dosing interval.
Enzyme CYP2D6: an important enzyme involved in the metabolism of medicines.
Idiopathic: adjective used primarily in medicine meaning arising spontaneously or from an obscure orunknown cause.
Idiopathic pain: pain for which the pathophysiological mechanisms are not identified.
Incident pain (or pain due to movement): pain that can be induced by simple movements such as walking, or a manoeuvre that would normally exacerbate pain, e.g. weight bearing on an extremity orpain during diagnostic or therapeutic procedures. Incident pain can occur during physical movements such as coughing or bladder spasm after urination.
Infant: a person from 29 days up to 12 months of age.

International drug control conventions: the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol, the Convention on Psychotropic Substances of 1971, and the UnitedNations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988.
Narcotic drugs: a legal term that refers to all those substances listed in the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol.
Neonate: a person from zero to 28 days of age.
Neuropathic pain: pain caused by structural damage and/or nerve cell dysfunction in either the peripheral or central nervous system (CNS). Pain is persistent even without ongoing stimuli.
Pain assessment tools: tools used to assess pain intensity or, in addition, other features of pain such as location, characteristics, frequency. Pain intensity measurement tools are often referred to as pain scales. Alternative terms are pain assessment instrument, method or measure.
Pain intensity: term is used interchangeably with pain severity and referring to the level of pain experienced and reported by the patient.
Pain severity: term is used interchangeably with pain intensity and referring to the level of pain experienced and reported by the patient.
Persisting pain: term as used in these guidelines is intended to cover long-term pain related to medical illness, for example pain associated with major infections (e.g. HIV), cancer, chronic neuropathicpain (e.g. following amputation), and episodic pain (e.g. in sickle cell crisis). For a full explanation ofthe type of pain covered, please refer to the Introduction. For explanations on different classificationsystems of pain, refer to Chapter 1. Classification of pain in children.
Prolonged-release (formulation): term is used interchangeably with sustained-release, slow-release, extended-release and controlled-release.
Psychometrics: field of study concerned with the theory and technique of educational andpsychological measurement, which includes the measurement of knowledge, abilities, attitudes, and personality traits. The field is primarily concerned with the construction and validation of measurementinstruments, such as questionnaires, tests and personality assessments.
Rotation of opioids: for the purposes of these guidelines, rotation (or routine rotation) of opioids is defined as the clinical practice of changing between different opioids in a set schedule, not in responseto a clinical problem, such as a side-effect, but as a preventive measure to limit future potential side-effects and dose escalation in patients that are anticipated to require long-term opioid therapy.
Switching of opioids: for the purposes of these guidelines, switching of opioids is defined as theclinical practice of changing to an alternative opioid because of dose-limiting side-effects and/or lack of analgesic effect.
Tolerance: a reduction in the sensitivity to a pharmacological agent following repeated administration. As a consequence, increased doses are required to produce the same magnitude of effect.
Withdrawal syndrome: the occurrence of a complex (syndrome) of unpleasant symptoms orphysiological changes caused by an abrupt discontinuation or a dosage decrease after repeated administration of a pharmacological agent. Withdrawal syndrome can also be caused by the administration of an antagonist.