Analgesics Flashcards
What are the classic analgesics?
Opiates and NSAID’s
What alternative classes of drugs can be used to treat certain types of pain?
Antidepressants and anti epileptics
What is acute/nociceptive pain?
Short term pain
What is chronic/neuropathic pain?
Long term persistent pain
What is allodynia?
Pain from stimulus that doesn’t normally cause pain
What is parasthesis?
painful feelings with no apparent stimulus e.g. pins and needles
Broad overview of opioids
They modify the transmission of pain signals and the subjective perception of pain
Broad overview of antidepressants and anti epileptics
Treats trigeminal neuralgia and neuropathic pain which is resistant to oipids
Broad overview of local anaesthetics in pain management
particularly effective for severe intractable or crescendo neuropathic pain emergency medicine
Mechanism of action of opioids
1+2 - decrease neurotransmitter release and block postsynaptic receptors
3 - activate inhibitory pathways
Advantages of opioids
Highly effective
Range of durations of effects
Variety of routes
Disadvantages of opioids
Side effects
Cautions/contradictions
Intwrations with other drugs
Neuropharmacology of opioids
- They mimic our endogenous pain killers
- They act as agonists at opioid receptors (3 types of receptors)
- Signal transduction (GPCR)
- Integrated physiology (act as suppressors)
Which receptors do most opioids interact with?
mu receptors
What type of pain do you treat with morphine?
Acute and chronic
What are the side effects of morphine and diamorphine?
Sedation, respiratory depression, constipation, nausea, vomiting, itching, tolerance, dependency and euphoria
What are SNRI’S? What kind of pain do they treat?
Serotonin and noradrenaline reuptake inhibitors. treat neuropathic pain but not in all patients. e.g. venafalaxine and duloxetine
What are SNRI’S? What kind of pain do they treat?
gdwbs
What is Duloxetine?
SNRI prescribed for peripheral neuropathic pain. Side effects of nausea vomiting somnolence insomnia and dizziness
What is Venafalaxine? what kind of pain does it treat?
SNRI prescribed to treat diabetic neuropathy. Side effects of nausea sedation headache and dizziness
Cautions/contradictions for SNRIs
Epilepsy, CV disease, diabetes, glaucoma, pregnancy/breastfeeding
What do SNRIS interact with?
alcohol, NSAID’S, tram adolescent, opioids, SSRIs
What is carbanazepine? what kind of pain does it treat?
Anti epileptic used to treat neuralgia and diabetic neuropathies
What is gabapentin? What type of pain does it treat?
Various neuropathic pain states. It is currently the drug of choice due to limited side effects.
What is lidocaine? what kind of pain does it treat?
Local anaesthetic sodium channel blocker that treats severe intractable or crescendo neuropathic pain
What is ketamine? what kind of pain does it treat?
Local anaesthetic glutamate receptor blocker that treats intractable or crescendo neuropathic pain
