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anaesthesia > Acute And Chronic Analgesic Drugs > Flashcards

Acute And Chronic Analgesic Drugs Flashcards

1
Q

Opioid receptos sub-types

A

μ (mu)
k (kappa)
δ (delta)

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2
Q

Examples of opioids

A 
Morphine
Pethidine 
Methadone 
Buprenorphine 
Butorphanol 
Fentanyl 
Alfentianil
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3
Q

pure μ agonists

A

Morphone, methadone and pethidine

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4
Q

partial μ agonist

A

Buprenorphine

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5
Q

k agonist and a μ antagonist

A

Butorphanol

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6
Q

Opioid that can’t be given IV

A

Pethidine

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7
Q

Requirements of an opioid drug to enable it to be given epidutally

A

Preservative-free or preservatives are not neurotoxic

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8
Q

Opioid metabolism and excretion

A

Metabolised by the liver and excreted in the urine

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9
Q

Opioids commonly used for pre-medication

A

Buprenorphine, methadone and butorphanol

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10
Q

How NSAIDs work

A

Blocking Cyclo-oxygenase enzymes (COX)

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11
Q

COX enzymes convert arachidonic acid to:

A

Prostoglandins

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12
Q

Accumulation of prostoglandins reaction

A

Red, swollen, warm and painful tissues

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13
Q

Uses for NSAIDs other than analgesia

A

Anti-inflamatory
Anti-pyretic (decreases body temperature)
Anti-endotoxaemic

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14
Q

NSAIDs should not be used in these cases

A
  • When a sterioid has been used
  • In renal failure
  • In cases of hypovolaemia
  • When an animal is hypotensive
  • Evidence of gastro-intenstinal ulceration, vomiting or diarrhoea
  • Animals with a clotting dysfunction
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15
Q

Why do NSAIDs have an effect on clotting?

A

Thromboxane A2 a factor which helps in clotting is blocked by NSAID administration

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16
Q

Which part of the pain pathway to NASIDs affect?

A

Transduction

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17
Q

Which part of the pain pathway do Alpha 2 adrenergic agonists affect?

A

Modulation and Perception

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18
Q

How Alpha 2 adrenergic agonists are handled by the body

A

Metabolised in the liver and excreted in the urine

19
Q

Routes of administration for Alpha 2 Adrenergic agonists

A

IV, IM, SC
Epidural route
Can be absorbed by mucous membranes

20
Q

Ketamine mode of action to produce analgesia

A

An antagonist at NMDA (N-methyl D-aspartate) receptors which are involved in the development of central sensitisation

21
Q

Type of pain Ketamine is most useful against.

A

Somatic pain

22
Q

Analgesic drugs that can produce a total absence of pain

A

Local anaesthetics

23
Q

Local anaesthetics work on which part of the pain pathway

A

Transmission

24
Q

How do local anaesthetics work?

A

To stop the transmission of electrical impulses along nerves by blocking the sodium channels in the nerve fibres

25
Q

Examples of local anaesthetic drugs

A
  • Lidocaine
  • Bupivicaine
  • Ropivacaine
  • Mepivacaine
  • Procaine
26
Q

Two subdivisions of local anaesthetics

A

Amide Linked group

Ester Linked Group

27
Q

Local anaesthetics belonging to the Amide Linked Group

A
  • Lidocaine
  • Bupivacaine
  • Mepivacaine
  • Ropivacaine
28
Q

How are Amide Linked local anaesthetics handled by the body?

A

Metabolised by the liver

29
Q

The only local anaesthetic that can be administered intravenously

A

Lidocaine

30
Q

Local anaesthetics belonging to the Ester linked group

A

Procaine

31
Q

How are Ester linked group local anaesthetics managed by the body?

A

Broken down in the blood by enzymes

32
Q

Duration and onset of action for lidocaine

A

5-10 minutes onset

Last up to 1 hour

33
Q

Duration and onset of action for Bupivacaine

A

30 minute onset

6-8 hour duration

34
Q

Local anaesthetic that produces less motor blockade than others

A

Ropivacaine

35
Q

How can maropitant produce analgesia?

A

Creates visceral analgesia by antagonising the NK1 receptors

36
Q

Non pharmaceutical methods of pain management

A
  • Providing a comfortable environment - correct temperature, quiet, comfortable bedding
  • Adequate nutritional support to aid wound healing
  • encourage normal sleeping patterns with light and dark times
  • grooming, TLC and quality time
  • Gentle physiotherapy - massage, hot and cold packs, passive range of motion exercises
  • support of fracture with bandages/sprints and wound dressings
  • ensuring an empty bladder and bowels
37
Q

What does galliprant target

A

Works as an antagonist at the EP4 receptor for PGE2

- can provide analgesia for osteoarthritis without affecting other enzymes

38
Q

What does bedvetinmab (librealla & Solensia) target?

A

Contains monoclonal antibody (mAb) which targets nerve growth factor (NGF)

39
Q

Paracetamol action

A

Non-acidic NSAID which acts at the level of the spinal chord COX enzymes, the opioid, serotoninergic and cannabinoid systems

40
Q

Dose rate for paracetamol

A

10mg/kg IV

Up to 30mg/kg PO BID or TID

41
Q

Mechanism of Gabapentin and Pregabalin

A

Binding to calcium channels in the CNS, reducing the production of pro-nociceptive inputs and facilitating descending inhibitory pathways

42
Q

Tramadol mechanism

A

works at the µ opioid receptors, 5HT receptors and noradrenaline receptors.

43
Q

NMDA Antagonist

A

Amantadine

44
Q

Additional therapies added to pain management plans

A

Acupuncture

Physiotherapy

anaesthesia (9 decks)

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