Pain and analgesia Flashcards
What are the two kinds of nociceptors?
- Mechanical nociceptor: activated by strong shearing force in skin
- Polymodal nociceptor: respond to many stimuli
What is hyperalgesia?
Becoming more sensitive to certain pain stimuli - increased pain from stimulus that usually provokes pain
What is allodynia?
Pain which is due to a stimulus that does not usually provoke pain
How do NSAIDS work?
They block both COX 1 and COX 2. These two are involved in producing prostaglandins.
COX 1 = Protection of gastric mucosa
COX 2 = Mediates pain, inflammation and fever
How do opioids work>
Stimulates the descending pathways
What are the weak opioids?
Codeine, dihydrocodeine, dextropropoxyophene and tramadol
What are the strong opioids?
Morphine, methadone, fentanyl, hydromorphone, diamorphine (Heroin), pethidine, oxycodone, buprenorphine, levorphanol and dextromoramide
What are side effects of opioids?
- Constipation
- Respiratory depression
- Dependence
- Nausea and vomitting
What is co-proxamol?
Paracetamol and dextropropoxyphene
What is co-codamol?
Paracetamol and codeine
What is nurofen plus?
Ibuprofen and codeine
What are common off label pain killers?
Anti-convulsants: gabapentin, pregabalin, carbamazepine
Anti-depressants: amitriptyline
