Analgesia Case Application Flashcards
validation for pain studies must include (3)
- mechanism
- pharmacology
- functional phenotype
how does the Von Frey filament cause pain
it involves little hairs brushing against a surface, which is agitating over time; involves Aβ fibers initially, but eventually the pathway converges and causes pain (via wide dynamic range neurons)
what are examples of pain models in dogs
- toe squeezer
- injection of joints with urate crystals
- colorectal distention
what are examples of pain models in cats
- thermal threshold
what are pain models in small ruminants/calves
- joint models
- thermal threshold
- castration
- disbudding
what are pain models in horses
- heat lamp
- electrical stimulation
- pressure on hoof
- colorectal distention
how are pain models different from clinical pain
with models, we apply nociception for a period of time until a cut-off value is reached; clinical pain tends to be constant
what are 5 ways that we can assess pain in animals
1) physiological changes
2) behavioural changes
3) response to stimuli
4) history of procedure and drug administration
5) response to treatment
what do we consider with clinical decision making re. pain
1) drugs administered (analgesics, time of administration)
2) type of procedure (minor vs major, complications, duration)
what is a type of scale we can use to assess pain in veterinary patients
visual analog scale; important to assess behaviour, expression, interactions
what are 8 pain indicators we can assess in vetmed
1) attitude
2) activity/posture
3) appetite
4) facial expression
5) interaction with people
6) response to handling
7) willingness to perform work
8) growth and production
what cardiopulmonary measure is correlated with pain/nociception
blood pressure
T/F HR is correlated with pain/nociception
F; ONLY BP
what does the Glasgow scale assess (7)
- posture
- activity
- vocalization
- attention to wound area
- demeanor
-mobility - response to touch
for the glasglow scale, when would you do rescue analgesia
if scores are 5/20 or 6/24
most scales involve (2)
- observation
- participation
a telltale sign of chronic pain in large animals is
weight loss with changes in eating and drinking (because C fibers and chronic pain involve every system)
what is a concern with post-insult analgesia
risk of central sensitization and wind-up
ideally, to treat pain we want to ______ modulation and _____ projection
enhance; prevent
what drugs prevent TRANSDUCTION of pain signals
- local anesthetics
- NSAIDs
- glucocorticoids
- opioids
what drugs prevent TRANSMISSION of pain signals
- local anesthetics
what drugs prevent MODULATION of pain signals
- local anesthetics
- NSAIDs
- opioids
- alpha 2 agonists
- ketamine
what drugs prevent PROJECTION of pain signals
- local anesthetics
- ketamine
- opioids
- alpha 2 agonists
- NSAIDs
what drugs prevent PERCEPTION of pain
- alpha-2 agonists
- phenothiazines
- benzodiazepines
- ketamine
- opioids
- inhalant anesthetics
- anticonvulsants
- tricyclic antidepressants
what are the names of the antidepressants
clomipramine and amitriptyline
how do amitriptyline and clomipramine work
1) serotonin and NE re-uptake inhibitors
2) block NMDA
3) block ion channels
4) direct and indirect opioid effects
what are some side effects of amitriptyline and clomipramine
- excitation
- sedation
- agitation
- ventricular arrhythmias
- death
