Pain Flashcards

1
Q

What is Phantom pain?

A

Pain sensation without any sensory input

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2
Q

What are the suggested causes of Phantom pain?

A

Cortical Reorganisation:
In homunculus
Central sensitisation: Permanent change in synaptic structure of dorsal horn

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3
Q

What receptors do endogenous opiates interact with to form Endogenous analgesia?

A

Opiate receptors on the nociceptor synaptic terminal. Prevents substance P release.

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4
Q

What is hyperalgesia?

A

An increased sensitivity to pain usually bc tissue has been damaged before.

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5
Q

What may be the result of chronic nociceptive pain?

A

Neuropathic/mixed pain

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6
Q

What may be the adverse effects of acute pain? (THINK STAB WOUND)

A

CV stress, respiratory compromise, hypercoagulation

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7
Q

Where do non-opioids act?

A

Nociceptors

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8
Q

Where do opioids act?

A

2 sites

1) Hyperpolarise post synaptically - reduce AP potential.
2) Presynaptic reduce transmission

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9
Q

What non-opioid prevents prostaglandin formation through the inhibition of COX?

A

NSAIDs

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10
Q

What non-opioid has a toxic liver damage risk?

A

Paracetamol

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11
Q

What activates the endogenous analgesic system?

A

Opioids

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12
Q

What are some of the side effects of opioids?

A

Nausea, vomiting, constipation, dizziness, somnolence, dry skin.

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13
Q

What opioids should be avoided with renal failure?

A

Morphine and codeine, toxic metabolites accumulate.

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14
Q

Where do spinal opioids act?

A

Dorsal horn of spinal cord.

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15
Q

What is neuropathic pain?

A

Pain arising bc of damage to nervous system.

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16
Q

Hyper excitable spinal cord is one mechanism of neuropathic pain, what is it?

A

Trauma or damage, increases the nociceptor input to the dorsal horn = more sensitive to pain (hyperalgesia)

17
Q

What is the mode of action of antidepressants?

A

Prevent re-uptake of noradrenaline and serotonin

18
Q

What are the most effective antidepressants?

A

Tri-Cyclic agents. Serotonin re-uptake inhibitors quite useless.

19
Q

What is the mechanism of Gabapentin?

A

Ca2+ channel blocker - stops excitatory neuropathic pain (not nociceptive)