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Year 2 Medicine > Analgesics, Anaesthetic and Sedative Drugs > Flashcards

Analgesics, Anaesthetic and Sedative Drugs Flashcards

1
Q

What is analgesia?

A

the inability to feel pain.

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2
Q

What are analgesics?

A

medication that acts to relieve pain.

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3
Q

PAIN

A
  • “An unpleasant sensory and emotional experience associate with actual or potential tissue damage”
  • “What ever the patient says it is”
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4
Q

Gate Theory pain

  • Melzack and Wall
  • … fibres lets pain through
  • … Fibres stimulate inhibitory neurones
  • … Pathways prevent central passage
A
  • Melzack and Wall
  • C fibres lets pain through
  • Ab Fibres stimulate inhibitory neurones
  • Descending Pathways prevent central passage
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5
Q

PAIN MODIFICATION

  • … C, A … fibres
  • Central Interpretation
  • Not just …!
A
  • Nociceptor C, A delta fibres
  • Central Interpretation
  • Not just Drugs!
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6
Q

Ladder - analgesia

  • …/Paracetamol
  • Weak …/ Local …
  • Strong …
A
  • NSAIDS/Paracetamol
  • Weak Opiates/ Local Anaesthetics
  • Strong Opiates
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7
Q

PAIN LADDER

A
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8
Q

OPIOIDS

  • Act on opioid Receptor and antagonised by …
  • Naturally occurring eg … ,…
  • Semi Synthetic eg …
  • Synthetic eg …
  • Weaker eg …
A
  • Act on opioid Receptor and antagonised by Naloxone
  • Naturally occurring eg Morphine ,Codeine
  • Semi Synthetic eg Diamorphine
  • Synthetic eg Fentanyl
  • Weaker eg Codeine
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9
Q

Naltrexone vs Naloxone

A

Naloxone is administered via nasal spray or auto-injector. Naltrexone is administered by an oral tablet or injection. While Naloxone is used to rescue people from an opioid overdose, Naltrexone helps to prevent relapse in people who have been clean for a minimum of 7 days.

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10
Q

Methods of administration - OPIOIDS

  • Intra… pca/infusion
  • Intra…
  • O…
  • Intra …/aerosol
  • …/spinal
A
  • Intravenous pca/infusion
  • Intramuscular
  • Oral
  • Intra nasal/aerosol
  • Epidural/spinal
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11
Q

Where are Receptors - OPIOIDS

  • … and … brain
  • Periaqueductal … Matter
  • Nucleus Raphe Magnus
  • Spinal Cord Posterior Horn 1 and 2
  • G I T
  • Peripheral Tissues
A
  • Pons and Mid brain
  • Periaqueductal Grey Matter
  • Nucleus Raphe Magnus
  • Spinal Cord Posterior Horn 1 and 2
  • G I T
  • Peripheral Tissues
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12
Q

Morphine

  • Effects
  • Side Effects
  • … Depression/… Loss
  • Nausea and …
  • …/…
  • Miosis
A
  • Effects
  • Side Effects
  • Respiratory Depression/Airway Loss
  • Nausea and Vomiting
  • Constipation/Pruritis
  • Miosis
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13
Q

Ketamine

  • … Receptors
  • Kappa and delta receptors
  • Not …
  • Analgesic local/general
  • Anaesthetic
  • Sedative
    • SIDE EFFECTS … phenomena
A
  • NMDA Receptors
  • Kappa and delta receptors
  • Not GABA
  • Analgesic local/general
  • Anaesthetic
  • Sedative
    • SIDE EFFECTS emergence phenomena
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14
Q

NSAIDS

  • Act by inhibiting Cyclooxygenase 1and 2
  • Analgesic, Antipyretic, Anti inflammatory
  • Side Effects
  • … Irritation
  • …ospasm
  • … Impairment
  • Platelet function …
A
  • Act by inhibiting Cyclooxygenase 1and 2
  • Analgesic, Antipyretic, Anti inflammatory
  • Side Effects
  • Gastric Irritation
  • Bronchospasm
  • Renal Impairment
  • Platelet function ASPIRIN
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15
Q

ASPIRIN

  • Acetylsalycilic acid
  • … phosphorylation
  • Air Hunger
  • … Syndrome - not given to children
A
  • Acetylsalycilic acid
  • Oxidative phosphorylation
  • Air Hunger
  • Reyes Syndrome - not given to children
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16
Q

Paracetamol

  • Mechanism of Action ? Central … effect/unknown
  • Side effects
  • … Hepatotoxicity/glutathione depletion
    • treat with N …
A
  • Mechanism of Action ? Central prostaglandin effect/unknown
  • Side effects
  • OVERDOSE Hepatotoxicity/glutathione depletion
    • treat with N acetylcysteine
17
Q

Other Analgesia

  • …lysis
  • Local …
  • …,antiepileptics
  • Guanethadine, k…, clonidine
  • Acu…
  • Inhalational … …/penthrane
  • Tramadol
A
  • Anxiolysis
  • Local anaesthetics
  • Antidepressants,antiepileptics
  • Guanethadine, ketamine, clonidine
  • Acupuncture
  • Inhalational Nitrous oxide/penthrane
  • Tramadol
18
Q

Anti-emetics

  • An antiemetic is a drug that is effective against … and …
A

An antiemetic is a drug that is effective against vomiting and nausea

19
Q

ANTI EMETICS

  • Avoidance due to sickness
  • Cyclizine
  • Ondansetron
  • hyoscine
  • Metaclopromide
  • Steroids
  • Prochlorperazine
  • cannabinoids
    • People …!
A
  • Avoidance
  • Cyclizine
  • Ondansetron
  • hyoscine
  • Metaclopromide
  • Steroids
  • Prochlorperazine
  • cannabinoids
    • People remember!
20
Q

Ramsay Sedation Scale

  • Patient …
  • Cooperative
  • Responds only to …
  • … response to Glabellar Tap/Shout
  • … Response
  • … response
A
  • Patient Anxious
  • Cooperative
  • Responds only to commands
  • Brisk response to Glabellar Tap/Shout
  • Sluggish Response
  • No response
21
Q

Benzodiazapines

  • Midazolam, D…, L…
  • Routes of administration
  • PHYSIOLOGY
  • Gabba- aminobutyric Acid
  • … Neurotransmittor
  • Receptors A and B
A
  • Midazolam, Diazepam, Lorazepam
  • Routes of administration
  • PHYSIOLOGY
  • Gabba- aminobutyric Acid
  • Inhibitory Neurotransmittor
  • Receptors A and B
22
Q

Side Effect of benzodiazapines

  • Over …
  • Loss of …
  • Respiratory …
  • ABC
  • … with caution (benzodiazepine antagonist)
  • Myth of safety ,Light Anaesthesia
A
  • Over Sedation
  • Loss of Airway
  • Respiratory Depression
  • ABC
  • Flumazanyl with caution (benzodiazepine antagonist)
  • Myth of safety ,Light Anaesthesia
23
Q

Flumazanyl with caution (benzodiazepine …)

A

Flumazanyl with caution (benzodiazepine antagonist)

24
Q

LOCAL ANAESTHETICS

  • C… is a local anaesthetic
A
  • Cocaine is a local anaesthetic
25
Q

Classification of local anaesthetics

  • … -NH.CO-
  • …,Prilocaine,Bupivacaine
  • Esters –CO.O-
  • … , Amethocaine
A
  • Amides -NH.CO-
  • Lignocaine,Prilocaine,Bupivacaine
  • Esters –CO.O-
  • Cocaine , Amethocaine
26
Q

Mechanism of Action - Local anaesthetics

  • Na Channel …
  • Un- ionized Drug Through Membrane into axoplasm
  • Protonated
  • Blocks … thus blocking action potential
A
  • Na Channel Blockade
  • Un- ionized Drug Through Membrane into axoplasm
  • Protonated
  • Blocks Channel thus blocking action potential
27
Q

Where to put them (local anaesthetic

  • Anatomy Local Blocks /…
  • Spinal … Caudal
  • Skin
  • …/Nebulised
  • Combination with GA Part of Triad
A
  • Anatomy Local Blocks /Ultrasound
  • Spinal Epidural Caudal
  • Skin
  • Aerosol/Nebulised
  • Combination with GA Part of Triad
28
Q

SIDE EFFECTS - Local anaesthetics

  • Skin/Subcutaneous
  • Brachial Plexus
  • Epidural
  • Caudal
  • Intercostal
  • VESSELS AND NERVES FOLLOW EACH OTHER
A
  • Skin/Subcutaneous
  • Brachial Plexus
  • Epidural
  • Caudal
  • Intercostal
  • VESSELS AND NERVES FOLLOW EACH OTHER
30
Q

TOXICITY - Local Anaesthetics

  • CARDIOVASCULAR
  • …,Cardiac …
  • CENTRAL NERVOUS SYSTEM
  • f…/Anxiety/Lossof …
  • Circumoral numbness
  • Ref Paper Mask 1990
A
  • CARDIOVASCULAR
  • Dysrythmias,Cardiac Depression
  • CENTRAL NERVOUS SYSTEM
  • Fitting/Anxiety/Lossof Consciousness
  • Circumoral numbness
  • Ref Paper Mask 1990

Year 2 Medicine (162 decks)

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