Pain Flashcards
What’s the definition of pain
An unpleasant sensory and emotional experience associated with actual or potential tissue damage
Acute pain : extent of the problem
Acute pain-most common reason for medical consult and >50% population make this visit during their life
Chronic pain : Extent of the problem
15.5 million people in England 34% of the population have chronic pain
Muscoskeletal conditions such as osteothritis back and neck pain are commonest cause of chronic pain
Why is chronic pain unequal and unfair
Chronic pain is linked to deprivation
Chronic pain more prevalent in women
Black people are more likely to have chronic pain has been a rise in pain in young people
Chronic pain phenotype is different
Changes in the physiology of the spinal cord in chronic as a result of repeated stimulation
Changes in functional mapping of the human brain
Pain pathway
First order neurones relay to second via neurotransmitters realease neurotransmissions third order neurons relay nocieptive impulses to cerebral cortex leading to sensation of pain
Descending control midbrain and brain stem project back to the spinal cord to modulate afferent pain transmission
Pathophysiology hyperalgesia and allodynia
Hyperalgesia means increased pain at normal threshold stimulation
Allodynia means other pain refers to pain from stimuli which are not normally painful
Pain which occurs other than area stimulation
What are simple analgesics
Paracetamol
Ibuprofen
Effects of opioids clinical observation
Analgesia
Respiratory depression
Nausea and vomiting
Antitussuive
Constipation
Itching
Euphoria
Dependence
Opioid classification weak
Weak opioid codeine codpiece mix
Dihydocodeine tramadol
Strong opioid
Morphine
Fentanyl
Diamorphine
Oxycodone
Hydrmorphone
Opioid receptors
Opioids interact with specific receptors
Three subtypes mop/dop/kop
Activated by endogenous opioid
G protein coupled
Reduces afferent flow of information
Reduce release of transmission in the spinal cord
