Analgesia Case Application Flashcards

1
Q

validation for pain studies must include (3)

A
  • mechanism
  • pharmacology
  • functional phenotype
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2
Q

how does the Von Frey filament cause pain

A

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)

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3
Q

what are examples of pain models in dogs

A
  • toe squeezer
  • injection of joints with urate crystals
  • colorectal distention
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4
Q

what are examples of pain models in cats

A
  • thermal threshold
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5
Q

what are pain models in small ruminants/calves

A
  • joint models
  • thermal threshold
  • castration
  • disbudding
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6
Q

what are pain models in horses

A
  • heat lamp
  • electrical stimulation
  • pressure on hoof
  • colorectal distention
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7
Q

how are pain models different from clinical pain

A

with models, we apply nociception for a period of time until a cut-off value is reached; clinical pain tends to be constant

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8
Q

what are 5 ways that we can assess pain in animals

A

1) physiological changes
2) behavioural changes
3) response to stimuli
4) history of procedure and drug administration
5) response to treatment

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9
Q

what do we consider with clinical decision making re. pain

A

1) drugs administered (analgesics, time of administration)

2) type of procedure (minor vs major, complications, duration)

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10
Q

what is a type of scale we can use to assess pain in veterinary patients

A

visual analog scale; important to assess behaviour, expression, interactions

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11
Q

what are 8 pain indicators we can assess in vetmed

A

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

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12
Q

what cardiopulmonary measure is correlated with pain/nociception

A

blood pressure

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13
Q

T/F HR is correlated with pain/nociception

A

F; ONLY BP

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14
Q

what does the Glasgow scale assess (7)

A
  • posture
  • activity
  • vocalization
  • attention to wound area
  • demeanor
    -mobility
  • response to touch
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15
Q

for the glasglow scale, when would you do rescue analgesia

A

if scores are 5/20 or 6/24

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16
Q

most scales involve (2)

A
  • observation
  • participation
17
Q

a telltale sign of chronic pain in large animals is

A

weight loss with changes in eating and drinking (because C fibers and chronic pain involve every system)

18
Q

what is a concern with post-insult analgesia

A

risk of central sensitization and wind-up

19
Q

ideally, to treat pain we want to ______ modulation and _____ projection

A

enhance; prevent

20
Q

what drugs prevent TRANSDUCTION of pain signals

A
  • local anesthetics
  • NSAIDs
  • glucocorticoids
  • opioids
21
Q

what drugs prevent TRANSMISSION of pain signals

A
  • local anesthetics
22
Q

what drugs prevent MODULATION of pain signals

A
  • local anesthetics
  • NSAIDs
  • opioids
  • alpha 2 agonists
  • ketamine
23
Q

what drugs prevent PROJECTION of pain signals

A
  • local anesthetics
  • ketamine
  • opioids
  • alpha 2 agonists
  • NSAIDs
24
Q

what drugs prevent PERCEPTION of pain

A
  • alpha-2 agonists
  • phenothiazines
  • benzodiazepines
  • ketamine
  • opioids
  • inhalant anesthetics
  • anticonvulsants
  • tricyclic antidepressants
25
Q

what are the names of the antidepressants

A

clomipramine and amitriptyline

26
Q

how do amitriptyline and clomipramine work

A

1) serotonin and NE re-uptake inhibitors
2) block NMDA
3) block ion channels
4) direct and indirect opioid effects

27
Q

what are some side effects of amitriptyline and clomipramine

A
  • excitation
  • sedation
  • agitation
  • ventricular arrhythmias
  • death