NSAIDS Flashcards
Somatoscisation
Emotional pain causing physical pain
Define pain
Unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage, or both
Name the 3 components of pain
Sensory discriminatory comp
Motivational- affective comp
Cognitive- evaluative comp
Describe the steps in feeling pain
Receptor activation (noiciceptors) Mediated by A-delta & C fibres
Describe A delta fibre
Thin, quick
Sharp localised pain
Withdraw hand
Describe C fibres
Thick, myelinated
Dull throbbing pain
Name NTs involved in pain pathways/ modulation/ transmission
Substance P Serotonin Histamine ACh Glutamate NA
What do endorphins regulate?
Regulate response to pain and stress
Endogenous opioid
What is somatic pain
Can localise pain
Usually involves organs/ systems
Describe somatic pain sensations
Aching, squeezing, stabbing, throbbing
What axons are activated in somatic pain?
Primary sensory afferents
What is stimulated in visceral pain?
Afferent receptors located in the viscera
Ill defined, cramping, gnawing, can be referred
Where can biliary referred pain be felt?
The shoulder
Name some NTs that are inflammatory mediators
Substance P
Serotonin
Bradykinin
Histamine
What is the role of prostaglandins in inflammation?
Enhances noiciceptive response to inflammation by lowering threshold to noxious stimuli
Causes to pain!
Why do NDAIDs inhibit to produce an analgesic affect?
Acharonic acid ➡️prostaglandins
What enzyme does paracetamol inhibit?
COX 2
Perhaps COX 3
What is arachidonic acid synthesised from?
Membrane phospholipids
What is produced by paracetamol metabolism that causes liver toxicity?
NAPQI
What is the antidote to paracetamol & what does it mop up?
Glutathiol
Mops up NAPQI
What is the affect of aspirin in low doses?
Inhibits COX1 in platelets
Anti- platelet activity
Aspirin high dose
COX 1 & 2
Anti platelet & anti inflammatory
Name 3 NSAIDs
Diclofenac
Indomethacin
Ibuprofen
The risk of what is significantly increased in Aspirin & NSAID combined use?
Gastric bleed
What is given to reduce chance if GI bleed in patients taking aspirin and NDAIDs?
H2 antagonists
Proton pump inhibitor
Reduce acid production in stomach
Name 2 COX 2 inhibitors (COXIBs)
And the effects!
What adverse effect are you more likely to experience?
Celecoxib
Etoricoxib
Anti inflammatory effects, no GI effects
But takes COX 1 route, ⬆️ platelet aggregation = stroke/ MI
