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Clinical 3rd Yr > Chapter 1- PAIN > Flashcards

Chapter 1- PAIN Flashcards

1
Q

Define visceral nociceptive pain

A

Hollow organs and smooth muscle, usually referred

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2
Q

Define neuropathic

A

Pain initiated or caused by a primary lesion or disease in the somatosensory nervous system

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3
Q

Define hyperalgesia

A

Heightened response to stimuli that is normally painful

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4
Q

Define allodynia

A

Pain caused by stimulus that does not normally provoke pain

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5
Q

Define inflammatory

A

A result of activation and sensitisation of the nociceptive pain pathway by a variety of mediators release at a site of tissue inflammation

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6
Q

Name 5 types of pain

A

1) nerve pain
2) bone pain
3) soft tissue pain
4) phantom pain
5) referred pain

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7
Q

What is fibromyalgia

A

Means pain coming from the muscles and fibrous tissues such as tendons and ligaments

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8
Q

Is fibromyalgia a chronic condition

A

YEAH 💊

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9
Q

What changes in amount of neurotransmitters are present in fibromyalgia

A

1) low levels of serotonin
2) low levels of NA
3) low levels of DA

Also high levels of substance P in CSF

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10
Q

What an you treat fibromyalgia with

A

Low dose TCAs e.g amitriptyline but tolerability and durability is poor

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11
Q

Can you use SSRIs to treat fibromyalgia

A

Yes but can cause insomnia do take in morning also although better tolerated than TCAs the beneficial aspects can be less reliable

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12
Q

Can you use SNRIs to treat fibromyalgia

A

Yeh u can

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13
Q

What drugs can be used in treating fibromyalgia

A

1) TCAs
2) SSRIs
3) SNRIs
4) pregabalin/gabapentin
5) tramadol
6) muscle relaxants e.g baclofen
7) zolpidem for sleep
8) antispasmodics for IBS

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14
Q

Name two random drugs that have proved promising in fibromyalgia

A

Pramipexole and pregabalin

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15
Q

Define acute pain

A

Pain of less than 3-6 months duration

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16
Q

Define chronic pain

A

Pain lasting more than 3-6 months duration, or persisting beyond the course of an acute disease, or after tissue healing complete

17
Q

Define acute on chronic pain

A

Acute pain flare superimposed on underlying chronic pain

18
Q

What’s first line for breakthrough pain and why

A

Oramorph due to its known and trusted therapeutic profile and low cost

19
Q

When are fentanyl patches considered for breakthrough pain

A

1) intolerance to morphine
2) patient unable to swallow
3) rapid onset and short duration of breakthrough pain

20
Q

Define somatic nociceptive pain

A

Musculoskeletal, cutaneous, often well localised

21
Q

Name 4 pain rating scales

A

1) verbal rating scale
2) numerical rating scale
3) visual analogue score (on a line)
4) visual recognition (faces)

22
Q

What are the 3 key side effect of opioids

A

1) constipation
2) nausea and vomitting
3) respiratory depression

23
Q

What is post herpetic neuralgia

A

Persistent nerve pain that occurs at the site of a previous attack of shingles

24
Q

Name 6 neuropathic clinical syndromes

A

1) post-herpetic neuralgia
2) trigeminal neuralgia
3) complex regional pain syndrome
4) phantom pain
5) central post stroke pain
6) neuropathic cancer pain

25
Q

What’s first line in the management of neuropathic pain

A

TCA or gabapentinoids

26
Q

Name three drugs not licensed for neuropathic pain

A

Amitriptyline
Imipramine
Nortriptyline

27
Q

What drug is licensed for painful diabetic neuropathy

A

Duloxetine

28
Q

What topical drug is licensed for post herpetic neuralgia

A

Lidocaine

29
Q

Pregabalin is licensed for what

A

Central and peripheral neuropathic pain

30
Q

What do you offer initially for trigeminal neuralgia

A

Carbamazepine

31
Q

What does CSCI stand for

A

Continuous subcutaneous infusion

32
Q

What are the 4 common places of subcutaneous infusion

A

Upper arm
Anterior/posterior chest wall
Abdomen
Thigh

33
Q

What does PCA stand for?

A

Patient controlled analgesia

Clinical 3rd Yr (11 decks)

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