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Pharmacology > Analgesics PT 1 > Flashcards

Analgesics PT 1 Flashcards

1
Q

Pain

A

Unpleasant sensory and emotional experience associated with actual or potential tissue

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2
Q

Nociception

A

Detection of noxious stimulus at the tissue level by nociceptors

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3
Q

Nociceptors

A

Free nerve endings of primary afferent neurons

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4
Q

Nociception pathway

A

Transduction- peripheral stimuli into action potential
Transmission- peripheral nerves to spinal cord and brain
Modulation- dorsal horn of spinal cord
Projection- 2nd order neurons project input to thalamus
Perception - integration of signal in the brain

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5
Q

Receptors located on the distal terminus of primary sensory nerve fibers

A
  • AB fibers
  • A delta fibers
  • C fibers
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6
Q

Chronic pain

A

Pain persist longer than is providing protection

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7
Q

Neuron alteration occurs through two main changes

A
  • peripheral sensitization-Nociceptor

- central sensitization- modulation

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8
Q

Hyperalgesia

A

Exaggerated perception of pain produced by a noxious stimulus

  • -primary -occurs in tissue damage
  • -secondary- beyond region of injury
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9
Q

Allodynia

A

Non noxious stimulus elicits pain

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10
Q

Main effect of Local anesthetic

A

Reversible blockade of transmission in peripheral nerves or spinal cord to stop pain signal from processing

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11
Q

Amides are metabolized where.

A

Liver

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12
Q

Esters are hydrolyzed by?

A

Plasma esterases

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13
Q

Amide have what type of half life?

A

Long T1/2 (2-6hrs)

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14
Q

Ester have what type of half life

A

Short half life (mins)

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15
Q

Metabolites are excreted in…

A

Urine

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16
Q

Route of administration of local anesthetic

A
  • topical (skin/wound site)
  • local infiltration (peripheral nerve block)
  • intravenous regional anesthesia (biers block)
17
Q

Regional anesthesia

A
  • minor procedures (skin biopsy)
  • lameness localization (nerve block on equine)
  • Epidural
18
Q

Pre and post operative analgesia

A

Nerve blocks and line blocks (closure in SX)

19
Q

Wound management

A

Intercostal nerve blocks (in between ribs)

20
Q

Peri-operative analgesia

A

Left displaced abomasum (LDA) surgery in ruminants

21
Q

Local anesthetic

A
  • completely block nociception at site of injury or surgery
  • reversible blockade of transmission in peripheral nerves or spinal cord to stop pain signal from progressing
  • administered directly at the site of action (topical or inject)
22
Q

Brachial plexus block

A
  • anesthesia for structures distal to elbow

- with nerve stimulation, effective from mid humerus distally

23
Q

Intercostal nerve block

A
  • use bupivicane
    • injections three ribs anterior and two ribs posterior
  • – thoracotomy , chest tube, rib fracture
24
Q

Benefits of regional analgesia

A
  • less sedation
  • decrease nausea and vomiting
  • decease CV and pulmonary complications
  • decrease morbidity and mortality
25
Q

Risk of regional analgesia

A
  • local anesthetic toxicity (use lowest effective dose)

- nerve injury (trauma, toxicity, ischemia

26
Q

Glutamate and NMDA receptors increase in excitatory neurotransmitters (NT) causing

A

Dorsal horn neural hyperexcitability

27
Q

NMDA receptor

A

Play central role in chronic pain

– dorsal horn wind up –> 2nd order neurons respond more intensely to repeated stimulation

28
Q

Glutamate

A

Powerful excitatory NT–> excite neurons

- increased of glutamate is able to activate normally closed NMDA receptors

29
Q

Neurologic blockade

A
  • Prevent depolarization
  • Block propagation of an action potential
  • – inhibiting the influx of sodium through voltage dependent NA+ channels
30
Q

All locally anesthetic are sodium channel blockers ..T or F

A

True

31
Q

Which ester is an-local anesthetic

A

Proparacaine

32
Q

Which of the following nociception processes is least affected by administration of local anesthetic drugs?

A

Perception..is not a target

Pharmacology (6 decks)

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