Analgesics, anaesthetic and sedative drugs Flashcards
Describe gate theory
C fibres lets pain through
Ab Fibres stimulate inhibitory neurons
Descending Pathways prevent central passage
Describe pain scoring
Linear
Smiley/Sad Faces
Mild Moderate Severe Excruciating
What drugs are used to treat pain
NSAIDS/Paracetamol
Weak Opiates/ Local Anaesthetics
Strong Opiates
What are opioids?
Act on opioid Receptor and antagonised by Naloxone Naturally occurring Semi Synthetic Synthetic Weaker
Give examples of naturally occuring opioids
Morphine ,Codeine
Give examples of semi synthetic opioids
Diamorphine
Give examples of synthetic opiods
Fentanyl
Give examples of weaker opiods
Codeine
List some methods of administration of analgesics
Intravenous pca/infusion Intramuscular Oral Intra nasal/aerosol Epidural/spinal
Where are the receptors found?
Multiple places, many different subtypes
What are the side effects of morphine
Respiratory Depression/Airway Loss
Nausea and Vomiting
Constipation/Pruritis
Miosis
Describe ketamine
NMDA Receptors Kappa and delta receptors Not GABA Analgesic local/general Anaesthetic Sedative SIDE EFFECTS emergence phenomena
What are NSAIDs?
Analgesic, Antipyretic, Anti inflammatory
What are the side effects of NSAIDs?
Gastric Irritation
Bronchospasm
Renal Impairment
Platelet function ASPIRIN
How do NSAIDs work?
Act by inhibiting Cyclooxygenase 1and 2
Describe the ramsay sedation scale
Patient Anxious Cooperative Responds only to commands Brisk response to Glabellar Tap/Shout Sluggish Response No response
List some benzodiazepines
Midazolam, Diazepam, Lorazepam
List the side effects of benzodiazepines
Over Sedation Loss of Airway Respiratory Depression ABC Flumazanyl with caution Myth of safety ,Light Anaesthesia
How do benzodiazepines work?
Gabba- aminobutyric Acid
Inhibitory Neurotransmittor
Receptors A and B
List some sedatives
Low Dose Vapours Ketamine Hyoscine Propofol Low dose Major Tranquillisers Alpha 2 agonists
What are the classifications of local anaesthetics?
Amides -NH.CO-
Lignocaine,Prilocaine,Bupivacaine
Esters –CO.O-
Cocaine , Amethocaine
Describe the mechanism of action of local anaesthetics
Na Channel Blockade
Un- ionized Drug Through Membrane into axoplasm
Protonated
Blocks Channel thus blocking action potential
What are the side effects of local anaesthetics
Skin/Subcutaneous Brachial Plexus Epidural Caudal Intercostal VESSELS AND NERVES FOLLOW EACH OTHER
Describe local anaesthetic toxicity
CARDIOVASCULAR - Dysrythmias,Cardiac Depression
CENTRAL NERVOUS SYSTEM - Fitting/Anxiety/Loss of Consciousness
Circumoral numbness
How do you treat adverse reactions to local anaesthetics
ABC
Oxygen
Lipid 20%
