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CNS > Analgesics > Flashcards

Analgesics Flashcards

1
Q

What are the major classes of drugs used for acute pain?

A 
NOPLAN 
NSAIDs
Opioids
Paracetamol 
Local anaesthetics
Alpha 2 agonists
NMDA agonists
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2
Q

What are the 3 effects of NSAIDs?

A

Anti-pyrexic
Anti-inflammatory
Analgesia

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3
Q

NSAIDs work by inhibiting COX. Is COX 1 or 2 ‘good’ or ‘bad’? Which one causes side effects when inhibited?

A

COX 1 - physiological, good. Side effects when inhibited

COX 2 - inflammatory, little side effects when inhibited

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4
Q

What are some side effects of NSAIDs?

A

GI ulceration
Clotting
Photosensitisation
Hypersensitivity

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5
Q

What are opioids used for? (2 effects)

A

Analgesia

Sedation

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6
Q

Where are opioid receptors found?

A

Throughout body

In CNS - mainly dorsal horn of spinal cord

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7
Q

What are the 2 ways of how opioids work?

A

Reduce excitatory neurotransmiter in nociceptors

Reduce neuronal response to nociceptive input

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8
Q

What are the 3 main types of opioid? What do the 2 main types do?

A

Mu - analgesia and narcosis (loss of consciousness)
Kappa - sedation and visceral analgesia
Delta

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9
Q

Give examples of opioids that are full mu agonists?

A

Methadone

Morphine

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10
Q

Give an example of a partial mu agonist?

A

Buprenorphine

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11
Q

What type of receptors does butorphanol effect?

A

Mu antagonist

Kappa agonist

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12
Q

How do opioids tend to be administered?

A

Parenterally

Poor bioavailability orally

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13
Q

What are the side effects of opioids?

A

Bradycardia
Respiratory depression
Reduced GI motility

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14
Q

What are the effects of paracetamol?

A

Analgesia
Antipyrexia
(Not anti-inflammatory)

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15
Q

Paracetamol MOA is unsure but could work via cannabinoid, serotonin receptors or COX 3 inhibition. How is paracetamol administered? Can it be given to all species?

A

IV or orally

NOT CATS - toxic, causes haemolysis

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16
Q

What are the side effects of paracetamol?

A

Hepatoxicity

Hypotension (IV formula)

17
Q

What are the 4 effects of local anaesthetics?

A

Analgesia
Anti-inflammatory
Anti-arrhythmmic
Prokinetic (increases GI motility)

18
Q

How do local anaesthetics work?

A

Act on sodium channels in cell membrane

Stop propagation of AP in neurones

19
Q

What are the 2 main classes of local anaesthetics? Where are they metabolised? Are they long or short lasting?

A

Amides - liver metabolism longer acting

Esters - tissue metabolism, shorter acting

20
Q

Give an example of each of the 2 types of local anaesthetics

A

Amide - lidocaine

Ester - procaine

21
Q

What is pKA in terms of pharmacological properties? What does a high pKA mean?

A

Degree of ionisation
Affects ability to cross membrane (amount of active drug)
High pKA - great amount of ionised drug, faster onset

22
Q

How does protein binding of a drug effect duration?

A

Greater protein binding = longer duration

23
Q

How does vessel diameter affect drug duration?

A

Vasodilated drug = shorter duration

24
Q

What are the side effects of local anaesthetics?

A

Effects other nerves except nociceptors - loss of motor function
CNS toxicity
Cardiac toxicity

25
Q

What are the 2 effects of alpha 2 adrenoreceptor agonists?

A 
Sedation 
Analgesia (shorter than sedation length)
26
Q

What are the 2 effects of NMDA antagonists?

A

Analgesia

Anaesthesia

27
Q

Give an example of a NMDA antagonist

A

Ketamine

Blocks NMDA receptor - anaesthesia

28
Q

How can ketamine be administered? Is it long are short acting?

A

IV, IM, SC, transmucosally

Short acting

29
Q

What are the side effects of ketamine?

A

Hypertonicity
Excitement
Myocardial depression
Increased peripheral sympathetic tone

30
Q

For chronic pain, acute analgesic drugs are given along with others. Give examples of drugs additionally given

A 
Gabepentin 
Amantadine
Antidepressants
Capsaicin 
Elk velvet antler

CNS (15 decks)

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