Analgesia

Question 1

Mild pain

Answer 1

NSAIDs, paracetamol

Question 2

Moderate pain

Answer 2

Weak opioids (codeine, tramadol) +/- NSAID + paracetamol

Question 3

Severe and persistent pain

Answer 3

Strong opioids (morphine, fentanyl) +/- NSAIDs + paracetamol

Question 4

What sensory neurones detect pain

Answer 4

NOCICEPTORS

Question 5

Where in the brain is pain perceived

Answer 5

Somatosensory cortex

Question 6

What is referred to as the gate control mechanism

Answer 6

The descending pain pathway

Question 7

Opiate mechanism of action

Answer 7

Endogenous opioids bind to opioid receptors
Ca2+ channels close decreasing the release of neurotransmitters
Opens K+ channels leading to hyperpolarisation

Question 8

Central effects of opiates

Answer 8

Nausea & vomiting, respiratory depression, sedative effect, hypotension, bradycardia, meiosis, antitussive effect

Question 9

Peripheral effects of opiates

Answer 9

Constipation, cholestasis, abnormal sensitivity to pain, urticaria, pruritis, bronchospasm

Question 10

Define tolerance

Answer 10

Decrease in pharmacological response following repeated or prolonged drug administrtion