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202: Theme 1, Fundamental neuroscience and the brain > Analgesics, Sedation, Local anaesthetic > Flashcards

Analgesics, Sedation, Local anaesthetic Flashcards

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1
Q

Gate theory

A

Stimuli from mechanoreceptors inhibit the spinothalamic tract
- Ab fibres stimulate inhibitory neurones of the ascending pathway

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2
Q

NICE ladder for analgesics

A
  1. NSAIDs/ Paracetamol
    - Aspirin
    - Ibuprofen
  2. Weak opiates/ Local anaesthetics
    - Lidocaine
  3. Strong opiates
    - Morphine
    - Diamorphine
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3
Q

Receptor location for opioids

A

Pons and midbrain

PGM

Nucleus raphe magnus

Spinal cord posterior horn 1 and 2

Gastrointestinal tract

Peripheral tissues

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4
Q

Morphine

  • Type/ action
  • Effects
  • Side effects
A

Opiate
- Mu receptor agonist

Side effects

  • Respiratory depression
  • Airway loss
  • Nausea and vomiting
  • Constipation
  • Pruritus
  • Miosis
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5
Q

Naloxone

A

Drug that antagonises opioid receptors

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6
Q

Ketamine

  • Action
  • Effects
  • Side effects
A

Action

  • NMDA antagonist
  • Kappa and delta agonist

Effects

  • Local and general analgesic
  • Anaesthetic
  • Sedative

Side effects
- Emergence phenomena

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7
Q

NSAIDs

  • Action
  • Effects
  • Side effects
A

Action
- COX 1 +2 inhibitor

Effects:

  • Analgesic
  • Antipyretic
  • Anti-inflammatory

Side effects

  • Gastric irritation
  • Bronchospasm
  • Renal impairment
  • Platelet impairment [aspirin]
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8
Q

Asprin

  • Action
  • Side effects
A

NSAIDs

  • Inhibits COX 1+2
  • Prevents production of prostaglandins

Side effects

  • Air hunger
  • Reyes syndrome [acute encephalopathy and fatty liver]
  • Oxidatie phosphorylation
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9
Q

Paracetamol

  • Mechanism
  • Side effects
A

Mechanism

  • Not really known
  • Possible inhibition of prostaglandin central

Side effects
- Overdose= hepatoxicity–>Glutathione depletion

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10
Q

Antidote for paracetamol overdose

A

N Acetylcysteine

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11
Q

Alternative analgesia

A

Anxiolytics [benzodiazepines]

Local anaesthetics

Antidepressants
Antiepileptics

Acupuncture

N20

Mg
Penthrox

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12
Q

Guanethadine

A

Antihypertensive
- Reduces the release of catecholamines

Also used for analgesia

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13
Q

Clonidine

A

Antihypertensive- alpha-2 agonist

Also used for analgesis

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14
Q

Antiemetics

A

Taken in conjunction with emetics: N20, Sevoflurane

Examples

  • Propofol
  • Cyclizine
  • Ondansetron
  • Hyoscine
  • Cannabinoids
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15
Q

Benzondiazapines

  • Action
  • Examples
A

Agonist for GABA-alpha receptor

Examples

  • Midazolam
  • Diazepam
  • Lorazepam
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16
Q

Side effects of benzodiazepines

A

Over sedation

Loss of airway

Respiratory depression

17
Q

Treating benzodiazepine overdose

A

ABC

Flumazenil- benzodiazepine receptor antagonist

18
Q

Drug used to reverse benzodiazepine

A

Flumazenil

19
Q

Amethocaine

A

Local anaesthetic

20
Q

Side effects of local anaesthetics

A

Toxicity

  • CVS
  • CNS

202: Theme 1, Fundamental neuroscience and the brain (27 decks)

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