Dental Pain Flashcards
What are the two main types of pain?
1-Musculoskeletal (somatic, inflammation)2-Visceral
Which 3 groups of neurotransmitters have a direct pain modulation on the brain?
1-Opioid narcotics2-Glu, GABA3-Antidepressants (5HT/NE)
What two Neurotransmitters have descending modulation effects in the spinothalamic tract?
-Serotonin drugs-Neuropeptides
Which three groups of drugs have an effect on pain in the dorsal horn?
1-Local anesthetic2-Opioids3-NSAIDs
Which two drugs affect peripheral nerves to modulate pain?
1-Local anesthetic2-Opioids
Which 4 drug groups modulate pain by acting on peripheral nociceptors?
1-Local anesthetic2-NSAIDs (COX 1/2 inhib)3-Acetaminophen4-Capsaicin
Arachidonic acid is converted by COX1 into PGE2 and Thromboxane A2 and has side effects in what 4 areas?
1-Gastric mucosal barrier2-Renal function3-Platelet Aggregation4-Vasoconstriction
Arachidonic acid is converted by COX2 into Prostaglandins and Prostacyclin and has side effects in what 3 areas?
1-Pain, inflammation, fever2-Renal function3-Vasodilation*COX-1 can contribute to this as well
What two drugs are Non-selective COX-1 and COX-2 inhibitors?
1-Salicylates (aspirin)2-Ibuprofen-like *Others as well
Which drug is a Selective Cox 2 inhibitor?
Celebrex (Celecoxib)
Which drug is NOT and NSAID but in a non-opioid analgesic?
Acetaminophen*does not help with inflammation
Salicylates are Cox-1 and Cox-2 inhibitors that are often combined with caffeine, acetaminophen or opioids for mild-moderate somatic pain. What are 3 dose dependent effects of these drugs?
1-Analgesia (600 mg)2-Antiinflammation (1 gm)3-Antipyretic (300-600 mg)*4 hour duration
What are the 4 side effects of salicylates?
1-G.I. Irritation and erosion2-Reyes syndrome in children (Cold/flu)3-Anti-clotting (lasts 1-2 weeks)4-RInging in ears (tinnitis, at higher doses)
Ibuprofen is a cox-1 and cox-2 inhibitor that is often a little better for mild-moderate pain and has what 3 effects?
1-Analgesia (400 mg)2-Anti-inflammation (800 mg)3-Antipyretic (400 mg)*4 hour duration
What are 3 side effects of ibuprofen?
1-GI ulcers (less than aspirin)2-Anti-clotting (less than aspirin)3-Cardiovascular effects