Chronic Pain Flashcards
What is chronic pain?
pain beyond expected period of healing and which no longer serves a useful purpose- secondary to physiological changes in signalling and dection of pain
What is neuropathic pain?
an inappropriate response caused by a dysfunction in the nervous system
What are common causes of neuropathic pain?
shingles; surgery; trauma; diabetic neuropathy; amputation
What is the efficacy of NSAIDs?
nociceptive pain
What is the MOA of NSAIDs?
inhibition of COx and prostaglandin synthesis
What are the SE of NSAIDs?
GI irritation; renal toxicitiy; potential drug-drug interactions; CVS SE
What is the efficacy of paracetamol?
analgesic and antipyretic- no anti-inflam
What is the MOA of paracetamol?
inhibition of central prostaglandin synthesis but not fully understoof
Waht is the efficacy of opiod analgesics?
nocicepitve pain; less effective in chronic states; partially effective in neuropathic pain
What is the MOA of opioids?
activate endogenous analgesic system
What are the SE of opioids?
N and V; constipation; dizziness/vertigo; somnolence; dry skin, pruritius
What is the efficacy of tricyclics?
neuropathic pain; CRPS; tension headache
What is the MOA of TCAs?
inhibition of neuronal reuptake of noradrenaline and serotonin
What are the SE of TCAs?
constipation; dry mouth; somnolence; abnormalities in HR or rhythm; insomnia; increased appetite
What is the efficacy of SSRIs and SNRIs?
neuropathic pain
What is the MOA of SSRIs and SNRIs?
inhibiti reuptake of noradrenaline or serotonin or both; provide analgesia by intesifying descending inhibition
Waht are the SEs of SSRIs and SNRIs?
N and V; constipation; somnolence; dry mouth; increased sweating and loss of appetite
What is the MOA of gabapentin?
binds to presynaptic voltage calcium channels
What is the MOA of pregabalin?
interacts with special N-type calcium channels
What is the MOA of carbamazepin?
blocks sodium and clacium channels
What are the SE of anticonvulsants?
sedation; dizziness; ataxia; peripheral oedema; nausea and weight gain