Behav. Sci. Pain Flashcards
function of pain
protect tissue
chronic regional pain syndrome
limb is cold, red, muscle wasting, nail changes
opioids
any drug that occupies opioid receptors; fentanyl, methadone
acts as hormone in blood - has lots of receptors in the body
opiates vs NSAIDS
opiates: hits receptor: don’t notice pain
NSAIDS: inflammatory pain
what is endogenous opioid synthesized from?
POMC -> B-lipotropin
mechanism of endorphin activity in pain management
CNS: involved in inhibiting GABA and thus disinhibiting dopamine
peripheral: inhibition of substance P (pain driver) and other tachykinin release
peripheral mechanism of release of endorphin
peripheral mediated by stress and ACTH co-release
-corticotrophs in the anterior pituitary synthesize ACTH and b-endorphin in equimolar amounts
central mechanism of release of endorphin
involves innervation of the hypothalamus, midbrain, and rostral medulla
-cell bodies of opioidergic neurons in the median eminence of the hypothalamus
what are the release mediators of endorphins?
5-HETE, LTA4, LTB4
angiotensin-II
5HT
what is the result of heroin on pain tolerance?
hyperalgesia
what is the #1 pain driver? how do we know?
glutamate - when it is blocked, there is no pain
NSAIDS mechanism
inhibit COX - enzyme for conversion of arachidonic acid to prostaglandins and thromboxane which provoke tissue inflammation
also reduces fever (because it’s caused by prostaglandin E2)
NSAIDS vs opioids
opioids = neuropathic pain NSAIDS = inflammatory pain (post traumatic, post-surgical)
AEDs
antiepileptic drugs: function by lowering a neuron’s ability to fire by hyperpolarization and disallowing depolarization
what are other uses of AEDs? why do they work for these?
bipolar, anxiety, substance withdrawal, migraines, fibromyalgia, diabetic neuropathy
why? these conditions involve neuronal excessive firing rates
pain on molecular level
significant Ca and Na influx
neuropathic pain on molecular level
Na, Ca, and GLU release
what are the AED Na channel blockers?
carbamazepine, lamotrigine, topiramate
what are the AED Ca channel blockers?
gabapentin and pregabalin
what are the side effects of AEDs
sedation, psychomotor/cognitive impairment, ataxia, tremor
topiramate uses and side effects
MIGRAINES
weight loss, acidosis, olighydrosis, glaucoma
pregabalin uses and SE
DIABETIC NEUROPATHY, FIBROMYALGIA
mild addiction, weight gain, sedation
gabapentin uses and SE
DIABETIC NEUROPATHY
weight gain, sedation
lamotrigine uses and SE
NO PAIN APPROVAL
stevens johnson syndrome rash
