Pain Flashcards
WHO
- non-opioid
- weak opioid
- strong opioid
adjuncts
nerve blocks
psychotropic:
amitryptiline
gabapentin
TENS machines (inhibitory neurons fire at the level of dorsal root ganglion)
Calcium channel blockers. ... Ketamine. Lidocaine. Capsaicin Tramadol. Botulinum toxi Miscellaneous Drug
psychological therapy
meds that work peripherally- nociceptors
NSAIDs, opioids, tramadol
meds that work centrally (on various parts of the brain)
paracetamol
opioids
tramatdol
meds that work on the descending inhibitory pathway spinal cord
opioid
tramadol
SNRI
TAD?
meds that work at the dorsal horn of the spinal cord
anticonvulsant gabapentinoids NMDA receptor antagonist (open a chloride channel) (acted on strongly by ketamine, pain memory) opioid tramdol TABs SNRI
MOA of NSAIDs
inhibit COX enzymes
?
side effects: GI bleeding (PGE are gastro-protective) ulceration renal failure exacerbate bronchospasms CV events
*caution over 65 y/o
paracetamol
COX-3 action
combo with NSAIDs
max 4g per day
children paracetemol
15mg/kg
10kg is allowed 150mg in a day
children paracetamol
15mg/kg
10kg is allowed 150mg in a day
opioids
kappa, mu
work in the spine
codeine
metabolised. by liver into morphine
morphine
flushing around drip (histaminic effect)
can cause hypotension
mood alterations (euphoric/loopy)
respiratory depression
morphine stimulus removal
feel very bad when taking morphine
respiratory depression - pain is not making you breathe faster
ketamine
NMDA antagonist
opioid tolerance, opioid side effect
low level works peripherally as an additive to morphine
in the brain, it sends consciousness somewhere else
