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Pharmacology > Analgesics (year 2) > Flashcards

Analgesics (year 2) Flashcards

1
Q

what are analgesics used for?

A

to manage pain

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2
Q

what is acute pain generally associated with?

A

tissue damage

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3
Q

animals rapidly alter behaviour when they have acute pain, why?

A

minimise damage and optimise healing conditions

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4
Q

describe chronic pain

A

persistent pain with no biological purpose of end point

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5
Q

what is the acronym used to remember the analgesics?

A

NO PLAN

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6
Q

what are the drugs used to manage acute pain?

A 
NSAIDs
Opioids
Paracetamol
Local anaesthetics
Alpha2 agonists
NMDA antagonists
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7
Q

what is the mode of action of NSAIDs?

A

they are COX inhibitors

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8
Q

what are the three effects of NSAIDs?

A

analgesia
anti-inflammatory
anti-pyrexia

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9
Q

what are the side effects of NSAIDs?

A

GI - vomiting, diarrhoea, ulcers
renal - alter blood flow
liver - idiosyncratic
clotting

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10
Q

give an example of an NSAID

A

meloxicam

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11
Q

what is the mechanism of action of opioids?

A

receptors throughout body but we target the dorsal horn of the spinal cord to reduce the action of excretory neurotransmitters in nociceptors

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12
Q

what are the three opioid receptors?

A

mu, kappa, delta

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13
Q

what are the different opioid receptors targeted for?

A

mu - analgesia

kappa - sedation, some analgesia

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14
Q

what are the three drug types that target opioid receptors?

A

full mu agonist
partial mu agonist
mu antagonist kappa agonist

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15
Q

what are some examples of full mu agonists?

A

morphine, methadone, pethidine, fentanyl

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16
Q

name a partial mu agonist

A

buprenorphine

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17
Q

why is buprenorphine (a partial mu agonist) used?

A 
last longer
fewer side effects
lower schedule (less paper work)
18
Q

name an opioid agonist-antagonist used in veterinary

A

butorphanol

19
Q

why might butorphanol be used?

A

if you want sedation but don’t require analgesia

20
Q

what are the effects of opioids?

A

analgesia and sedation

21
Q

name some side effects of using opioids

A 
bradycardia
respiratory depression
reduced GI motility
excitment
dysphoria
euphoria
vomiting
22
Q

opioids have an antagonists available for the mu receptors, what is it called?

A

naloxone

23
Q

how is paracetamol administered?

A

orally or IV

24
Q

what are the effects of paracetamol?

A

analgesia and anti-pyrexia

25
Q

what species should paracetamol not be used in?

A

cats - metabolise it to a toxic metabolite that damages RBCs

26
Q

what are the side effects of paracetamol use?

A

hepatotoxicity

hypotension (IV administration)

27
Q

name the two classes of local anaesthetic drugs

A

amides and esters

28
Q

what are some examples of amides used as local anaesthetics?

A

lidocaine, bupivacaine, mepivacaine

29
Q

where are amides metabolised?

A

liver

30
Q

give an example of an ester used as a local anaesthetic

A

procaine

31
Q

what is the mechanism of action of local anaesthetics?

A

act on sodium channels to prevent propagation of action potentials

32
Q

are esters or amides longer acting local anaesthetics?

A

amides as they require metabolisation from the liver not just any tissue

33
Q

what are the effects of local anaesthetics?

A

analgesia, anti-inflammatory, anti-arrhythmic

34
Q

what are the some general features of local anaesthetics?

A

higher pKa means more ionising so the slower the onset of action
more lipid soluble the faster the onset
greater protein binding means longer duration of action
the more vasodilation it causes the shorter the duration of action

35
Q

what are the side effects of local anaesthetics?

A

loss of autonomic tone
loss of motor activity
CNS toxicity
cardiac toxicity

36
Q

alpha2 agonists are synergistic with which other analgesic group?

A

opioids

37
Q

what is the mechanism of action NMDA antagonists?

A

block NMDA receptors involved in the pain pathway in the CNS

38
Q

name an NMDA antagonist used for acute pain management

A

ketamine

39
Q

what are the effects of ketamine?

A

analgesia and anaesthesia

40
Q

what are the side effects if NMDA antagonists?

A

excitement, hypertonicity, myocardial depression, sympathetic stimulation

41
Q

name some drugs used to manage chronic pain

A

gabapentin
amantadine
antidepressants
capsacin

42
Q

what questions do we ask when choosing an analgesic?

A

What type of pain is expected?
What degree of pain is expected, or already present?
Which drugs are available?
How easy is a certain drug to administer to that individual?
Is the drug licensed in the species?
Is it safe to use?

Pharmacology (25 decks)

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