anaesthetics Flashcards

1
Q

what are the three actions of NSAIDs

A

analgesia, anti-inflammatory, antipyretic

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2
Q

what is the pathway involved in prostaglandin synthesis

A

Phospholipase A2=>arachidonic acid=>COX=> prostaglandins

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3
Q

What is the purpose of prostaglandin and bradykinin in the injured tissue

A

reduction of pain threshold (allodynia) for tissue protection

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4
Q

what GPCRs do Prostaglandins act on in C fibres

A

Gq EP1, increase in calcium, neurotransmitter and so sensitivity, increase in bradykinin,

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5
Q

what is the effect of increase in peripheral pain signaling

A

upregulation of COX2 in dorsal horn=> increase in PGE2

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6
Q

What is the effect of PEG2 in CNS

A

Gi EP3=> raised cAMP and Ca=> heat production and reduced loss; Gs EP2 => phosphorylation of glycine receptors => increased pia perception

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7
Q

what are the common sites for COX1

A

platelets, gastric mucosa and renal vasculature, renal parenchyma

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8
Q

what is the full name of COX

A

Cyclooxygenase

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9
Q

what molecules are synthesised by COX enzymes

A

converts arachidonic acid to various eicosanoids=>prostaglandins, prostacyclin and thromboxane.

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10
Q

describe the mechanism behind protective effect of small doses of aspirin

A

irreversible inhibitor of COX1. Platelet => not replaced => anti-coagulant activity; mucosal cells => replaced and production of prostacyclin maintained

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11
Q

what parts of the brain are responsive to endogenous opioids

A

thalamus, limbic system, spinal cord, afferent peripheral terminal

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12
Q

What are the types of endogenous opioids

A

Enkephalins, Endorphins, Dynorphins

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13
Q

what are the 3 types of opioid receptor types and what type of receptor type are they

A

Mu, Kappa and Delta Gi

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14
Q

what is the intracellular effect of opioids

A

decreases cAMP and so Ca => reduced neurotransmitter (substance P) mu also positively coupled to K+ channels and Kappa inhibits voltage gated ion channels

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15
Q

what channels mediates most of the therapeutic effect

A

mu =>hyperpolarisation via opening K and closing Ca voltage gated channels

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16
Q

name some schedule 2 controlled drugs

A

Diamorphine (heroin), Morphine, Remifentanil, Pethidine