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Neuro > FINAL-Intro to Pain > Flashcards

FINAL-Intro to Pain Flashcards

1
Q

IASP Pain Definition

A

Unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

Nociceptive Visceral Pain

A

Associated with internal organs

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3
Q

Nociceptive Somatic Pain

A

Soft tissue/myalgic pain

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4
Q

Two Major cats of Pain

A

Nociceptive

Neuropathic

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5
Q

Neuropathic Pain def

A

Stimuli abnormally processed by the nervous system

  • disengaged from noxious stimuli or healing process
  • nerve damage
  • tingling, sharp, shooting, skin crawling
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6
Q

Maladaptive (Functional) Pain

A

Abnormal operation of nervous system

  • disengaged from noxious stimuli or healing
  • Pain appears to be generated from inbalance in pro-nociceptive signals and anti-nociceptive signals in the CNS
  • influenced heavily by stress, anxiety etc.
  • typically seen i n fibromyalgia, IBS
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7
Q

Acetylsalicylic Acid

A

Aspirin
Max dosing: 4,000
325-1000 q 4-6hrs

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8
Q

Acetaminophen

A

Tylenol
Parenteral-Ofirmev
Max Dose: 4000mg/day
325-1000mg q 4-6hrs

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9
Q

Meclofenamate

A

Max dose-400mg/day

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10
Q

Mefenamic Acid

A

Ponstel

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11
Q

Diclofenac

A

Cataflam, Voltaren gel
Max dose 150
Flector Patch: 2x daily to painful area

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12
Q

Indomethacin

A

150 max dose day

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13
Q

Ibuprofen

A

Motrin
Caldolor IV
3400mg/day

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14
Q

Naproxen

A

Naprosyn

1000max dose daily

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15
Q

Naproxen Na

A

Aleve

660mg/day max

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16
Q

Celecoxib

A

Celebrex

400mg/day max

17
Q

Meloxicam

A

Mobic
Max 15mg/day
7.5 mg dosing!

18
Q

What NSAID has the least amount of CV risk?

A

Naproxen

19
Q

What NSAIDs have the least amount of risk for GI bleeding?

A

Celecoxib, Nabumetone, Meloxicam

20
Q

If aspirin is indicated, should you give ibuprofen?

A

No because it interferes with the antiplatelet effect of aspirin

21
Q

Hyperalgesia

A

Exaggerated painful response to normally noxious stimuli

22
Q

Allodynia

A

Painful response to normally non-noxious stimuli

bed sheet on foot, exposure to cold

23
Q

A- δ (delta) fibers description…

A

Large diameter, sparsely myelinated that evoke sharp, well localized pain

24
Q

C-fibers description…

A

Small diameter, Unmyelinated produce aching, poorly localized pain

25
Q

Generation of action potentials that are conducted along

A

afferent A delta and C nerve fibers to the spinal cord

26
Q

What is Maladaptive Pain?

A

Functional Pain AKA Dysfunctional Pain

  • Think of it as abnormal operation of the nervous system that become disengaged from noxious stimuli or healing
  • Imbalance in pro-nociceptive signals and anti-nociceptive signals in CNS

-This kind of dysfunctional pain is heavily influenced by stress, anxiety, depression, or illness

27
Q

Diseases that are Maladaptive Pain?

A

Fibromyalgia, IBS, Intersitial Cystitis

28
Q

Opioids bind to what receptors?

A

kappa, mu, delta

29
Q

Opioids MOA

A

Bind to GPCR via 2nd messengers to reduce adenylate cyclase, open K+ channels, and moify Ca2+

Bind to mu, delta, kappa

30
Q

Dorothy Effect

A

Dopamine + Opioid Response

Dopamine is our primary reward system and
Endorphins and opioid receptors maximize our achieve the reward

Occurs in susceptible individuals on exposure to opioids (depression, chronic stress/anxiety, genetic predisposition, substance abuse dx)

31
Q

Drug of choice for Trigeminal Neuralgia

A

TEGRETOL(Carbamazepine)

32
Q

SNRI approved for Pain and fibromyalgia

A

CYMBALTA (Duloxetine)

33
Q

Opioids on list…

A 
Morphine
Hydrocodone
Oxycodone
Oxymorphone
Hydromorphone
Fentanyl
Methadone
Codeine
34
Q

TCA adjuncts

A

Amitriptyline (ELAVIL)
Nortriptyline (PAMELOR)
Desipramine(NORPAMIN)
Imipramine(TOFRANIL)

35
Q

Antiepileptic Adjuncts

A

Carbamazepine (TEGRETOL)
Pregabalin (LYRICA)
Neurontin (GABAPENTIN)

36
Q

SSRI adjunct

A 
Sertaline
Citalopram
Escitalopram
Paroxetine
Fluoextine
37
Q

SNRIs

A

Duloxetine
Venlafaxine
Milnacipran (SAVELLA)

Neuro (12 decks)

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