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BDS3 Oral Surgery > Analgesia > Flashcards

Analgesia Flashcards

1
Q

What inflammatory mediators cause pain?

A

Leukotrienes

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2
Q

What does aspirin do at a cellular level?

A

Has anti-inflammatory properties
Inhibits COX 1&2 which subsequently reduces production of prostaglandins
COX-1 - reduces platelet aggregation

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3
Q

What are some problems with aspirin (including contra-indications)?

A

Hypersensitivity - particularly with asthma
Aspirin burn
Contra-indicated for peptic stomach ulcers as it increases bleeding/ blood flow to GIT.

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4
Q

What molecules are released in response to tissue injury and how do they cause pain?

A

Tissue injury leads to breakdown of arachidonic acid to form prostaglandins.
Prostaglandins DO NOT CAUSE PAIN but sensitise the tissues to become more susceptible to feeling the pain.

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5
Q

What are the properties of aspirin?

A

Analgesic (pain relief)
Antipyretic (reduce fever)
Anti-inflammatory

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6
Q

What are prostaglandins?

A

Vasodilators - affect capillary permeability

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7
Q

Why do you need to take care when prescribing aspirin to asthmatics?

A

Hypersensitivity
reactions include:
Acute bronchospasm/ asthma type attacks
ALSO
Skin rashes and angioedema

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8
Q

Why should aspirin be avoided for patient’s taking warfarin?

A

Enhances warfarin - increases free warfarin by displacing it from binding sites on plasma proteins.
Active increasing bleeding tendency

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9
Q

What are the complete contraindications for aspirin?

A

Children and adolescents under 16; breast-feeding (reye’s syndrome)
Previous or active peptic ulceration
Haemophilia
Hypersensitivity to aspirin or any other NSAID

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10
Q

What is max. dose of ibuprofen?

A

2.4g

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11
Q

What are some symptoms of ibuprofen OVERDOSE?

A

Nausea
Vomiting
Tinnitus

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12
Q

What patients should u have caution when prescribing ibuprofen?

A

Previous or active peptic ulceration
Elderly
Pregnancy and lactation
Renal, cardiac or hepatic impairment
History of hypersensitivity to aspirin or other NSAID
Asthma
Patients taking other NSAIDs
Patients on long term systemic steroids

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13
Q

Properties of paracetamol

A

Analgesic
Antipyretic
Little or NO anti-inflammatory action
No effect on bleeding time
Does not interact significantly with warfarin
Less irritant to GIT
Suitable for children

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14
Q

What is paracetamols mode of action and what does this result in?

A

Indirectly inhibits COX - especially in the brain

Analgesia
Antipyretic action
No reduction in peripheral inflammation

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15
Q

What patients should you have caution when prescribing paracetamol?

A

Hepatic impairment
Renal impairment
Alcohol dependence

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16
Q

What is the max. dose for adults and children for paracetamol?

A

Adults - 4g daily (8 tablets)
Children - depends on weight/ age

17
Q

Where do opioid analgesics work?

A

Act in the spinal cord - especially dorsal horn pathways
Central regulation of pain

18
Q

What is a problem with opioids?

A

Tolerance - to achieve the same therapeutic effects the dose of the drug needs to be progressively increased.
Effects on smooth muscle - constipation and urinary and bile retention

19
Q

What are the main side-effects of opioids?

A

Nausea
Vomiting
Drowsiness

20
Q

What are the 2 opioids we can prescribe as dentists?

A

Dihydrocodeine
Tramadol

21
Q

What are the complete contraindications for opioids?

A

Acute respiratory depression
Acute alcoholism
Raised intracranial pressure/ head injury - interferes with respiration, affects pupillary responses vital for neurological assessment.

22
Q

What is the only method of dihydrocodeine dentists can prescribe and what is the dose?

A

Oral
30mg every 4-6 hours as necessary

23
Q

What are serious interactions with opioids?

A

Antidepressants
Dopaminergics

24
Q

What drug/ antidote should be used for opioid overdose?

A

Naloxone

25
Q

What drug on the dental list can be used to control trigeminal neuralgia and what class does it come under?

A

Carbamazepine
Neuropathic and functional pain

BDS3 Oral Surgery (4 decks)

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