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Immune and Lymphatic System > drugs and pain management > Flashcards

drugs and pain management Flashcards

1
Q

what are opioids and what are they used to treat

example is

A

Opioids are ‘morphine-type’ medications, used to treat moderate or severe pain. These include codeine

Opioids can be used for a short time after surgery or trauma (acute pain).
addictive so withdrawn symptoms

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2
Q

where do opioids act

A

acting on receptors located on neuronal cell membranes

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3
Q

what are the side effects of opioids

A

addictive so withdrawal symptoms
Drowsiness: This usually passes within a few days once you are used to the dose.
Constipation: All opioids cause constipation. Laxatives are often recommended
Sickness: Anti-sickness medication may be paired with them
Dry mouth
Confusion, Hallucinations
Slow breathing
Feeling tired, dizzy or faint.

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4
Q

what is an NSAID

A

Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to relieve pain, reduce inflammation, and bring down a high temperature and causes of long-term pain

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5
Q

how to NSAIDS work

A

inhibition of the enzyme cyclooxygenase (COX).

Cyclooxygenase is required to convert arachidonic acid into thromboxanes, prostaglandins, and prostacyclins.

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6
Q

side effects of NSAID

A

indigestion – including stomach aches, feeling sick and diarrhoea
stomach ulcers – these can cause internal bleeding and anaemia; extra medicine to protect your stomach may be prescribed to help reduce this risk
headaches
drowsiness, dizziness
allergic reactions
in rare cases, problems with your liver, kidneys or heart and circulation, such as heart failure, heart attacks and strokes

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7
Q

what are corticosteroids

A

Commonly referred to as steroids, corticosteroids are a type of anti-inflammatory drug. They are typically used to treat rheumatologic diseases, like rheumatoid arthritis, lupus, or vasculitis (inflammation of the blood vessels).

administered as an injection at the site of musculoskeletal injuries.

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8
Q

symptoms of corticosteroids

A

increased appetite – potentially leading to

weight gain

acne

thinned skin that bruises easily

increased risk of infections

mood changes, mood swings and depression

diabetes

high blood pressure

osteoporosis (weak and brittle bones)

withdrawal symptoms caused by suppression of the adrenal glands

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9
Q

mechanism of action of paracetamol

A

inhibition of prostaglandin (PG) synthesis or through an active metabolite influencing cannabinoid receptors

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10
Q

what are muscle relaxants

A

Muscle Relaxants are used to reduce pain from tense muscle groups, most likely through sedative action in the central nervous system

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11
Q

how to anti-anxiety drugs work

A

Anti-anxiety drugs work on pain in three ways: they reduce anxiety
they relax muscles
they help patients cope with discomfort.

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12
Q

how to anticonvulsant drugs work

A

help relieve pain caused by damaged nerves.

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13
Q

which spinal tract carries pain to the brain

A

lateral spinothalamic tract

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14
Q

what type of nerve ending to nociceptors have

A

free nerve endings

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15
Q

what inflammatory mediators sensitise pain

A

Bradykinin, histamine, prostaglandins( inhibit amount)

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16
Q

what are the two types of pain conduction

A

fast response -sharp stabbing

slow response aching burning

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17
Q

in a fast pain response what fibres are used

A

Adelta fibres - large and myelinated

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18
Q

in a slow pain response what fibres are used

A

C fibres- small and unmeylinated

19
Q

Do C fibre input involve spinal interneurones?

A

yes

20
Q

in a withdrawal reflex with an interneurone what type of fibre is used

A

Adelta fibres

21
Q

what is visceral pain

A

vague pain, that is not localised and is like a deep squeeze pain and occur when pain receptors in the chest, abdomen or pelvis are activated
initiated by intention, ischemia

22
Q

what does neuropathic pain result from

A

trauma or infection to nerve damage

23
Q

a local anaesthetic is administered via a spinal epidural but at what level?

A

L3-4

24
Q

what does a lumbar puncture remove and at what level

A

CSF

L3

25
Q

local anaesthetics are proton acceptors when they are admisiterd they block receptors. What kind of drugs do this

A

cocaine and lidocaine

26
Q

PGE2

A

pain sensitization, renal arteriole dilation, ductus arteriosus patency

27
Q

PGF2alpha

A

Bronchoconstriction, uterine contraction

28
Q

PGI2

A

inhibition of platelet aggregation, Vasodilation

29
Q

TXA2

A

activation of platelet aggregation, vasoconstriction

30
Q

what does COX-1 do

A

Constitutive (background)
- gastric protection
platelet aggregation
Renal protection

31
Q

what does COX-2

A

Inducible ( repspnsive)
Inflammation
HYperalgesia( painheightened) - desired analgesic effects

32
Q

does aspirin cause irreversible acetylation

A

yes

very effective in anti- platelet action

33
Q

where are opioid receptors found

A

Brain
GI tract
spinal cord
and peripherally in response to injury

34
Q

what G protein to opioid receptors use

A

gi

35
Q

Which receptor sub type is the main site of action for opiod analgesics and also respiratory depression ?Mu ( top one) is the main site of action for opioid analgesics and also respiratory depression.

A

MU(top one)

36
Q

main side effects of opioids

A

Analgesia

Constipation

Sedation

Respiratory depression

Mood alteration

nausea and vomiting

37
Q

what does a prodrug become

A

active drug- metabolised in the body

38
Q

what are endogenous opioids

A

Body’s own analgesics

39
Q

endorphins/ enkephalins

A

Peptides produced in pituitary and hypothalamus

Released both locally ( brian/spinal cord) and systemically

40
Q

is fentanyl lipid soluble

A

yes

41
Q

3 stages of the analgesic ladder

A

Stage 1. Paracetomal NSAID
Stage 2. Weak opioid - codeine
Stage 3 : strong opioid - morphine

42
Q

what does patient controlled analgesia allow

A

Allows patient to regulate analgesic dosing schedule

If dosage becoming excessive drowsiness prevents further self-administration

43
Q

do endorphins bridge the spinal processing gate control

A

yes - they create negative control and inhibit the pathway at that level

Immune and Lymphatic System (19 decks)

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