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PHARM.E2.Opioid Analgesics-Pain Perception and the Human Brain > PAIN > Flashcards

PAIN Flashcards

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1
Q

What are opioids used for?

A

reduce pain-defense mech to retract from danger/injurious agents

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2
Q

What system does opioid act on?

A

CNS; thalamus, basal ganglia, anterior cingulate, insula–most consistently activated in acute pain

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3
Q

How does the brainstem come into play?

A

BS and the descending pain modulatory system play a role in the ANTICIPATION and perception of pain. (can occur quickly)

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4
Q

Clinical chronic pain

A

causes increasing activation of the pre-frontal cortical region which implies that chronic pain disturbs the cognitive and emotion perception and processing of everyday experience.

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5
Q

At what levels can pain come into play?

A

..

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6
Q

What does the interaction between pre-frontal cortex, basal ganglia, and amygdala correlate to?

A

hypervigilence…

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7
Q

In what area does the opioid take action?

A

..

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8
Q

What immediately happens when tissue is damaged?

A

Immediate release of inflamm chemicals (excitatory NT)-eg histamine and bradykinin

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9
Q

What does bradykinin stimulate?

A

the release of

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10
Q

What are the two types of transmission?

A

chemical..mechanical (order?)

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11
Q

What are the steps of perception?

A

..

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12
Q

What two groups are pain divided into?

A

Acute and chronic pain

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13
Q

Examples of acute pain

A
  • *heart attack
  • acute appendicitis
  • *bone fracture
  • muscle sprain
  • prolapsed disc
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14
Q

Examples of chronic pain

A
  • cancer
  • neuropathy
  • inflammation
  • distensions
  • eruptions
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15
Q

Notes of Acute Pain

A

..

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16
Q

Notes of Chronic Pain

A

..

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17
Q

Acute pain management

A

reduce pain–>treat cause

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18
Q

Chronic pain management

A

focused on reducing the pain

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19
Q

A&C Pain management

A
  • minimize pain, limit disability, maximize person’s fxn

- MULTIDISCIPLINARY-blends physical, emotional, intellectual and social variables

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20
Q

4 main effects of chronic pain on the patient

A
  1. physical functioning
    - ability to perform activities of daily living
    - sleep disturbances
  2. psychological morbidity
    - depression
    - anxiety
    - anger
    - loss of self-esteem
  3. social consequences
    - relationship with family/friends
    - intimacy/sexual activity
    - social isolation
  4. societal consequences
    - healthcare cost
    - disability
    - lost workdays
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21
Q

What is the most successful pain treatment?

A

OPIOIDS

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22
Q

Important figures

A

Hippocrates, Marcus Aurelius, Galen of Pergamum, Solomon Snyder, Candace Pert

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23
Q

Ways to make/get OPIOID

A
  1. extraction
  2. Synthesis
  3. endogenous (endorphins)
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24
Q

What receptor do opioids use?

A

the OPIOID RECEPTOR! in the nervous system

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25
Q

What are the different types of receptors?

A

*Delta
Kappa
Mu
Nociceptin

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26
Q

Function of Delta Receptors

A
  • analgesia
  • antidepressant effects
  • physical dependence
27
Q

Function of Kappa Receptors

A
  • spinal analgesia
  • sedation
  • miosis
  • inhibition of ADH release
  • dysphoria
28
Q

Define analgesis

A

absence of pain without loss of consciousness; pain consists of BOTH sensory and affective (emotional) components. Opioids analgesic are unique in that they reduce both aspects of the pain experience

29
Q

Define antidepressant

A

alleviate mood disorder (some are related to euphoria..recreation drugs)

30
Q

Define physical dependence

A

chronic use of a drug that has produced tolerance

31
Q

Define sedation

A

.

32
Q

Define dysphoria

A

.

33
Q

how do opioid induce analgesia?

A

by reducing the amount of information

34
Q

LOCATION, LOCATION, LOCATION

A

(**Where are which receptors expressed???)

  • presynpatic: mu, kappa, delta
    • reduce calcium and increase potassium=decrease/inhibit transmitter release (hyperpolarize=reduce amt of AP)
  • postsynaptic: mu
    • increase/stimulate potassium–>IPSP
35
Q

At which two sites do opiod act?

A

pre and post synaptic opioid receptors

36
Q

Review p 22 diagram

A

..

37
Q

Acute effects of Opiates

A

inhibit LC neurons by activating K+ channels and inhibiting Na-dependent inward current
-via G-proteins AND regulation of Na current via inhibition of cAMP pathway

38
Q

Chronic effects of Opiates

A

cAMP, PKA, TF

39
Q

CNS effects-Euphoria

A

..

40
Q

CNS effects-Sedation

A

..

41
Q

CNS effects-Cough Suppression

A

..

42
Q

CNS effects-Respiratory Depression (** major prob with OD)

A

..

43
Q

CNS effects-Miosis

A

..

44
Q

CNS effects-Temperature

A

..

45
Q

STRONG Opiods

A

MORPHINE, METHADONE, MERPERDINE

46
Q

Moderately STRONG Opioids

A

CODEINE, OXYCODONE

47
Q

Receptor agonist-ANTagonist Opioids

A

PENTAZOCINE, BUPRENORPHINE

48
Q

ANTagonist Opioids**

A

NALOXONE**

49
Q

Why not automatically use STRONG opiods?

A

dependence=no bueno

50
Q

MORPHINE

A

..

51
Q

MEPERIDINE

A

..

52
Q

HYDROCODONE

A

..

53
Q

CODEINE

A

..

54
Q

Euphoria Diagram ..online ppt

A

..

55
Q

PENTAZOCINE

A

+(delta agonist)/-(kappa agnist, mu ANTagonist)–TWO enantiomers

Indication:
Side Effects:
Withdrawal:

56
Q

NALOXONE

A

..

57
Q

Signs!!!

A
  • blue lips

- unresponsive to pain stimuli

58
Q

Naloxone (narcan) if effective, but….

A

Opiod is still around, after injection in ~2hrs high (and OD) will return.

59
Q

OD-Nervous system

A

.

60
Q

OD-Heart, blood and circulation

A

.

61
Q

OD-Stomach

A

.

62
Q

OD-sexual organs

A

.

63
Q

METHADONE

A

.

PHARM.E2.Opioid Analgesics-Pain Perception and the Human Brain (1 decks)

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