Analgesia And Pain Management Flashcards
Pain types
Nociceptive
Inflammatory
Neuropathic
Nociplastic
Inflammatory mediators released when tissue is damaged
K+
H+
Bradykinin
Histamine
5HT
NO
Which pathway produces leukotrienes and prostanoids
Arachidonic pathway
Neuropathic pain mechanisms
Altered ion channel expression
Ectopic and spontaneous discharge
Emphatic conduction
Collateral sprouting at Pri afferents
Sprouting of sympathetic neurones at DRG
Nociplastic pain mechanisms
Central pain sensitisation
Dysfunctional inhibitory pathways
Pain inhibitory pathways
GABA
Opioid
Mono aminergic
Cannabinoid
Nociceptive pain
Appropriate physiological detection of painful stimulus
Inflammatory pain
Enhanced nociception in the presence of inflammation
Neuropathic pain
Pain initiated or caused by a primary lesion/dysfunction in the nervous system
Nociplastic pain
Pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage
How long does acute pain last
<12 wks
How long does chronic pain last >12wks
Pain measurement tools
VAS Visual analogue score
VRS verbal rating score
Observer scoring
BPI
Magill pain questionaire
SF36
EQ5D
3 steps in pain relief ladder
Non opioid
Weak opioid
Strong opioid
Non opioid painkillers
Aspirin
Paracetamol
Ibuprofen
Diclofenac
COX2 inhibitors
Weak opioid painkillers
Codeine
Dihydrocodeine
Tramadol
Strong opioid painkillers
Morphine
Hydromorphone
Oxycodone
Buprenorphine
Fentanyl
Methadone
What symptoms does paracetamol improve
Moderate pain
Pyrexia
Main effect of paracetamol overdose
Liver damage
Paracetamol administration
Oral
IV
PR
What drug class is naproxen
NSAID
How does naproxen inhibit prostaglandin
COX1 and 2 inhibition
Naproxen adverse effects
GI bleeding
GI ulcers
Renal effects
CVS effect
Tramadol and tapentadol administration
Oral
IV
IM
Which pathway does Tramadol target
Monoaminergic pathway
Tramadol and tapentadol side effects
Nausea
Vomiting
Dizziness
Sweating
Opioid MOA
Mimic endogenous analgesic peptides and act on opioid recpetors
Endogenous analgesic peptides
Endorphins
Dynorphins
Enkephalins
3 main opioid receptor types
Mu
Kappa
Delta
Which opioid receptor does morphine act on
Mu
Morphine administration
IV
IM
SC
oral
Epidural
Intrathecal
IA
Morphine side effects
Constipation
Nausea
Pruritis
Drowsiness
Medications for neuropathic pain
Anti neuropathic agents
Anticonvulsants
Antidepressants
Topical creams
Antineuropathic agents
Pregabalin
Gabapentin
Carbamazepine
Sodium valproate
Phenytoin
Is THC Or CBD psychoactive
THC
What type of molecule are endocannabinoids
Lipids
Anaesthetic techniques
Topical application
Local infiltration
Simple nerve block
Plexus block
Epidural infusion