Analgetika Flashcards

0
Q

Beskriv NMDA’s funktion

A

Øger dannelsen af NO i dorsalhornet -> hyperalgesi. Laver også Wind-up, som giver stærkere og stærkere smerte ved gentagen påvirkning (selvforstærkende).

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1
Q

Hvad er forskellen på A-delta-fibre og C-fibre?

A

A-delta: myeliniserede, hurtige, akut smerte.

C: umyeliniserede, langsomme, dumpe og vedvarende

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2
Q

Nævn 5 smertestillende klasser

A
Opioider: my, delta og kappa
NMDA-antagonister: glutaminerge
Alfa-2 agonister: præsynaptisk
NSAID: cox-1 og cox-2
5-HT og NE-udtake hæmmere
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3
Q

Beskriv smertens vej

A

Transduktion, transmission, modulation, perception

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4
Q

Hvad virker på transduktion?

A

Lokalanæstesi, opioider, NSAIDs

% sensation

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5
Q

Hvad virker på transmission?

A

Lokalanæstesi, alfa-2 agonister

% impuls

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6
Q

Hvad virker på modulation?

A

Lokalanæstesi, opioider (systemiske), alfa-2 agonister (systemiske), NMDA-antagonister, tricykliske antidepressiva, AChE-hæmmere (ikke klinisk)

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7
Q

Hvad virker på perception?

A

Inhalations- og injektionsanæstetika, opioider, alfa-2 agonister, benzodiazepiner

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8
Q

Hvilke receptorer stimulerer opioider?

A

My, delta og kappa

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9
Q

Hvad er opioidernes virkningsmekanisme?

A

Stimulering af receptorerne -> G-proteinmedieret hæmning af cAMP -> nedsat Ca++ influx -> nedsat transmitter release.
Yderligere øget ledning af K+ -> hyperpolarisering.

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10
Q

Hvad er den vigtigste bivirkning ved opioider?

A

Respirationsdepression

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11
Q

Morfin

A

Agonist, my, smerte, præanæstesi

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12
Q

Codein

A

Agonist, my, kappa, delta, hoste

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13
Q

Metadon

A

Agonist, my, præanæstesi

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14
Q

Fentanyl

A

Agonist, my, smerter

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15
Q

Buprenorfin

A

My-agonist og kappa-antagonist. Post-op smerte, moderate

16
Q

Butorphanol

A

My-antagonist, kappa-agonist (fuld effekt). Akut + post-op smerte. Kolik

17
Q

Naloxon

A

Antagonist, især my. Ophæver effekt af fx morfin. Kan udløse abstinenser