Analgesics, anaesthetic and sedative drugs

Question 1

Describe gate theory

Answer 1

C fibres lets pain through
Ab Fibres stimulate inhibitory neurons
Descending Pathways prevent central passage

Question 2

Describe pain scoring

Answer 2

Linear
Smiley/Sad Faces
Mild Moderate Severe Excruciating

Question 3

What drugs are used to treat pain

Answer 3

NSAIDS/Paracetamol
Weak Opiates/ Local Anaesthetics
Strong Opiates

Question 4

What are opioids?

Answer 4

Act on opioid Receptor and antagonised by Naloxone
Naturally occurring 
Semi Synthetic  
Synthetic 
Weaker

Question 5

Give examples of naturally occuring opioids

Answer 5

Morphine ,Codeine

Question 6

Give examples of semi synthetic opioids

Answer 6

Diamorphine

Question 7

Give examples of synthetic opiods

Answer 7

Fentanyl

Question 8

Give examples of weaker opiods

Answer 8

Codeine

Question 9

List some methods of administration of analgesics

Answer 9

Intravenous pca/infusion
Intramuscular
Oral
Intra nasal/aerosol
Epidural/spinal

Question 10

Where are the receptors found?

Answer 10

Multiple places, many different subtypes

Question 11

What are the side effects of morphine

Answer 11

Respiratory Depression/Airway Loss
Nausea and Vomiting
Constipation/Pruritis
Miosis

Question 12

Describe ketamine

Answer 12

NMDA Receptors
Kappa and delta receptors
Not GABA
Analgesic local/general
Anaesthetic
Sedative
SIDE EFFECTS emergence phenomena

Question 13

What are NSAIDs?

Answer 13

Analgesic, Antipyretic, Anti inflammatory

Question 14

What are the side effects of NSAIDs?

Answer 14

Gastric Irritation
Bronchospasm
Renal Impairment
Platelet function ASPIRIN

Question 15

How do NSAIDs work?

Answer 15

Act by inhibiting Cyclooxygenase 1and 2

Question 16

Describe the ramsay sedation scale

Answer 16

Patient Anxious
Cooperative
Responds only to commands
Brisk response to Glabellar Tap/Shout
Sluggish Response
No response

Question 17

List some benzodiazepines

Answer 17

Midazolam, Diazepam, Lorazepam

Question 18

List the side effects of benzodiazepines

Answer 18

Over Sedation
Loss of Airway
Respiratory Depression
ABC
Flumazanyl with caution
Myth of safety ,Light Anaesthesia

Question 19

How do benzodiazepines work?

Answer 19

Gabba- aminobutyric Acid
Inhibitory Neurotransmittor
Receptors A and B

Question 20

List some sedatives

Answer 20

Low Dose Vapours
Ketamine
Hyoscine 
Propofol Low dose
Major Tranquillisers
Alpha 2 agonists

Question 21

What are the classifications of local anaesthetics?

Answer 21

Amides -NH.CO-
Lignocaine,Prilocaine,Bupivacaine
Esters –CO.O-
Cocaine , Amethocaine

Question 22

Describe the mechanism of action of local anaesthetics

Answer 22

Na Channel Blockade
Un- ionized Drug Through Membrane into axoplasm
Protonated
Blocks Channel thus blocking action potential

Question 23

What are the side effects of local anaesthetics

Answer 23

Skin/Subcutaneous
Brachial Plexus
Epidural
Caudal
Intercostal
VESSELS AND NERVES FOLLOW EACH OTHER

Question 24

Describe local anaesthetic toxicity

Answer 24

CARDIOVASCULAR - Dysrythmias,Cardiac Depression
CENTRAL NERVOUS SYSTEM - Fitting/Anxiety/Loss of Consciousness
Circumoral numbness

Question 25

How do you treat adverse reactions to local anaesthetics

Answer 25

ABC
Oxygen
Lipid 20%