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HARRISSONS > Pain > Flashcards

Pain Flashcards

1
Q

The cell bodies of the primary sensory afferents are located in the?

A

Dorsal root ganglia within the vertebral foramina

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2
Q

What is the largest diameter afferent fiber?

A

A-beta

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3
Q

Afferent fiber that respond maximally to LIGHT touch and or moving stimuli.
They are present primarily in the nerves that innervate the skin.

A

A-beta

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4
Q

Afferent fibers that respond MAXIMALLY ONLY to intense (painful) stimuli and defines them as PRIMARY AFFERENT NOCICEPTORS (PAIN RECEPTORS)

A

A-delta and C-fiber

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5
Q

The small diameter MYELINATED Afferent fibers

A

A-Delta

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6
Q

The UNMYELINATED Afferent fibers

A

C-fiber / axon

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7
Q

Chemical irritants

A

ATP
SEROTONIN
BRADYKININ
HISTAMINE

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8
Q

When intense, repeated or prolonged stimuli are applied to damaged or inflamed tissues, the threshold for activating primary afferent NOCICEPTORS is _____ and the frequency of firing for all stimulus intensities is ______

A

LOWERED

HIGHER

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9
Q

11 amino acid that Causes vasodilation, degranukates masts cells, chemoattractant to leukocytes, and increases production and release of inflammatory mediators

A

Substance P

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10
Q

Crucial for pain sensation in humans wherein disruption causes deficits in pain and temperature discrimination

A

Spinothalamic tract

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11
Q

Mediates the purely sensory aspects of pain, its location, intensify and quality

A

Somatosensory cortex

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12
Q

subserve the affective or unpleasant emotional dimension of pain like fear

A

Frontal cortex

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13
Q

Pain will worsen following administration of an inner substance can increase its perceived intensity

A

Nocebo effect

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14
Q

Greatly exaggerated pain sensation

A

HYPERPATIA

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15
Q

Very lightest moving stimulus evokes exquisite pain

A

ALLODYNIA

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16
Q

Effective for postherpetic neuralgia who have prominent ALLODYNIA

A

Topical preparation 5% lidocaine

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17
Q

Constellation of spontaneous pain and signs of sympathetic dysfunction following injury

A

Complex regional Pain Syndrome. CRPS

18
Q

Constellation of spontaneous pain and signs of sympathetic dysfunction following injury with identifiable nerve injury

A

CRPS 2 or post traumatic neuralgia

If severe CAUSALGIA

19
Q

CRPS WITHOUT OBVIOUS NERVE INJURY

A

RSD - Reflex sympathetic dystrophy

or CRPS type 1

20
Q

Particularly effective for mild to moderate headache and for pain of musculoskeletal origin

A

Aspirin, acetaminophen and NSAIDS

21
Q

Inhibits cyclooxygenase but do not have anti-inflammatory action

A

ACETAMINOPHEN

22
Q

Most common used analgesic

A

COX INHIBITORS (Aspirin, acetaminophen and NSAIDS)

23
Q

With chronic use, most common side effect of Aspirin, acetaminophen and NSAIDS

A

GASTRIC IRRITATION

24
Q

Gastric irritation is most severe in?

A

ASPIRIN

25
Q

Irreversibly acelytates platelet cyclooxygenase thereby interferes its coagulation of the blood and may cause gi bleeding

A

ASPIRIN

26
Q

Chronic use of NSAID causes side effects

A

Hypertension
Nephrotoxicity
GI IRRITATION

27
Q

Significant benefit in postoperative pain because they do not affect blood coagulation

A

COX 2 selective drugs

28
Q

C/I in post op px because they impair platelet mediated blood clotting and thus associated w increased bleeding

A

Non-selective cox inhibitors

29
Q

Most potent pain relieving drugs currently available with broadest range of efficacy and provide most reliable and effective method for rapid pain relief

A

OPIODS

30
Q

OPIOD related side effect can be reversed rapidly with narcotic antagonist

A

NALOXONE

31
Q

OPIOD receptor

A

U receptor

32
Q

Metabolite of meperidine

A

Normeperidime

33
Q

At higher doses of meperidine (>1g/d), accumulation of meperidine produce

A

Hyper-excitability and seizures not reversible by NALOXONE

34
Q

Respiratory depression by OPIODS are common when used with

A

BENZODIAZEPINES

35
Q

Lock out period of PCA

A

5-10 minutes

36
Q

Bolus doses
Morphine ___
Hydromorphone ___
Fentanyl ____

A

Morphine ___1mg
Hydromorphone ___0.2mg
Fentanyl ____ 10 microgram

37
Q

Morphine intrathecally vs IV

A

Morphine intrathecally: 0.1-0.3mg

Morphine IV : 5-10mg

38
Q

OPIODS intranasal
Transdermal
Oral mucosa

A

OPIODS:
intranasal -BUTORPHANOL
Transdermal PATCHES- FENTANYL AND BUPRENORPHINE
Oral mucosa- FENTANYL

39
Q

OPIOD antagonist that is restricted to the intestinal lumen by limited absorption
Effective in lowering duration of persistent Ileus following abdominal surgery

A

ALVIMOPAN OR ENTEREG

40
Q

OPIOD antagonist available in SQ administration and with no penetration into the CNS
Relief in OPIOD induced CONSTIPATION

A

Methylnatrexone (RELLISTOR)

HARRISSONS (62 decks)

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