L24 - Analgesics, Anaesthetic and Sedative Drugs

Question 1

define pain

Answer 1

“An unpleasant sensory and emotional experience associate with actual or potential tissue damage”

“What ever the patient says it is”

Question 2

describe the gate theory

Answer 2

C fibres lets pain through

Ab Fibres stimulate inhibitory neurones

Descending Pathways prevent central passage

Question 3

describe the pain score

Answer 3

Linear

Smiley/Sad Faces

Mild Moderate Severe Excrutiating

Question 4

describe the ladder

Answer 4

NSAIDS/Paracetamol

Weak Opiates/ Local Anaesthetics

Strong Opiates

Question 5

what are opioids antagonised by

Answer 5

-Naloxone

Question 6

how do you administer morphine

Answer 6

Intravenous pca/infusion

Intramuscular

Oral

Intra nasal/aerosol

Epidural/spinal

Question 7

where are the opioid receptors found

Answer 7

Pons and Mid brain

Periaqueductal Grey Matter

Nucleus Raphe Magnus

Spinal Cord Posterior Horn 1 and 2

G I T

Peripheral Tissues

Question 8

what are the sub-types of opioid receptors

Answer 8

MU 1 and 2 OP3

Delta OP1

Kappa OP2

Question 9

what are the side effects of morphine

Answer 9

• Nausea and vomiting
• Constipation
• Respiratory depression
• Miosis
• Pruritis

Question 10

describe the pharmacology of ketamine

Answer 10

NMDA Receptors

Kappa and delta receptors

Not GABA

Analgesic local/general

Anaesthetic

Sedative

SIDE EFFECTS emergence phenomena

Question 11

describe the pharmacology of NSAIDS

Answer 11

Act by inhibiting Cyclooxygenase 1and 2

Analgesic, Antipyretic, Anti inflammatory

Side Effects :
-Gastric Irritation

• Bronchospasm
• Renal Impairment
• Platelet function-ASPIRIN

Question 12

describe the Ramsay sedation scale

Answer 12

• Patient Anxious
• Cooperative
• Responds only to commands
• Brisk response to Glabellar Tap/Shout

-Sluggish
Response

-No response

Question 13

name a benzodiazepine

Answer 13

diazepam

Routes of administration
PHYSIOLOGY
Gabba- aminobutyric Acid
Inhibitory Neurotransmittor 
Receptors  A and B

Question 14

name the classifications of local anaesthetics

Answer 14

• Amides -NH.CO-
  1) Lignocaine,Prilocaine,Bupivacaine

2)Esters –CO.O-
Cocaine , Amethocaine

Question 15

what is the mechanism of action of local anaesthetics

Answer 15

• Na Channel Blockade
• Un- ionized Drug Through Membrane into axoplasm
• Protonated
• Blocks Channel thus blocking action potential

Question 16

describe the toxicity of local anaesthetics

Answer 16

CARDIOVASCULAR:
-Dysrythmias,Cardiac Depression

CENTRAL NERVOUS SYSTEM:
-Fitting/Anxiety/Lossof Consciousness
Circumoral numbness