Pain Flashcards
an appropriate physiological response to a painful stimulus via an intact nervous system
nociceptive pain
an inappropriate response caused by a dysfunction in the nervous system
neuropathic pain
what are the symptoms of neuropathic pain? (6)
shooting or burning pain sensations
tingling and numbness
allodynia
hyperalgesia
pain produced in response to a stimulus that is normally not painful (such as light touch)
allodynia
increase in pain response with lowering of the pain threshold, to a stimulus that is normally painful (such ass pinprick)
hyperalgesia
what are the causes of neuropathic pain? (6)
spinal cord injury Multiple sclerosis Stroke Diabetic neuropathy post-Herpetic neuralgia Trigeminal neuralgia
what is the first line treatment of trigeminal neuralgia?
caarbamazepine
what are the choices for initial treatment for neuropathic pain? (4)
amitriptyline, duloxetine, gabapentin, pregabalin
what is the mode of action of amitriptyline?
tricyclic antidepressant that inhibits neuronal reuptake of noradrenaline and serotonin
what is the mode of action of duloxetine?
inhibits reuptake of serotonin and noradrenaline
what is the mode of action of gabapentin?
primarily inhibits high-voltage-activated presynaptic Ca2+ channels; designed as GABA analogue
what is the mode of action of pregabalin?
primarily inhibits high-voltage-activated presynaptic Ca2+ channels; designed as GABA analogue
what are the side-effects of amitriptyline? (6)
constipation, weight gain, dry mouth, mydriasis, sedation and hypotension
what are the side-effects of duloxetine? (6)
nauseaa, dry mouth, constipation, somnolence, loss of appetite and hyperhidrosis
what are the side-effects of gabapentin? (5)
somnolence, dizzineses, peripheral oedema, weight gain and ataxia
what are the side-effeectss of pregabalin? (5)
somnolence, dizzineses, peripheral oedema, weight gain and ataxia
A chronic condition that causes neuropathic pain, usually after surgery or minor injury and usually affecting the arm or leg?
complex regional pain
what are the signs aand symptoms of complex regional pain? (7)
progresssive disproportionate pain
sweelling
skin changes
motor dysfunctions (tremor or dystonia)
how is complex regional pain managed?
physiotherapy and amitriptyline
what occurs in 10% of stroke patients?
central post-stroke pain
what causes neuropathic pain in central post-stroke pain?
due to thalamic lesions
A —–, rapidly improving hemiplegia with initial ——— followed in ——– to ——- by allodynia and dysesthesia
mild
paraesthesia
weeks
months
a mild and rapidly improving hemiplegia with initial parassthesiaa followed in weeks to months by
allodynia and dysesthesia
what can occur on the paralysed side?
hemi-chorea movements
