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SL22044 Neuroscience > Pain and analgesics 4 (analgesic drugs) > Flashcards

Pain and analgesics 4 (analgesic drugs) Flashcards

1
Q

Which method of administering analgesics can be patient controlled?

A

Intravenous injection

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2
Q

What is an epidural?

A

Delivering a drug directly into the spinal cord

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3
Q

When is epidural administration used?

A

Childbirth

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4
Q

Why is epidural administration used in childbirth?

A

Know where pain will come from so know where it will enter the spinal cord so can administer drug directly into that bit of the spinal cord

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5
Q

What are the benefits of epidural administration of drugs in childbirth?

A

Minimises opioids going into the mothers bloodstream

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6
Q

Why is fentanyl used often in surgery?

A

Short half life

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7
Q

Which drugs are administered via a transdermal patch?

A

fentanyl and buprenorphine

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8
Q

Big advantage of transdermal patches?

A

Good way to steadily administer drug, keep dose at a consistent level

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9
Q

Which level of administration is used for treating chronic pain?

A

Transdermal patch

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10
Q

What is buccal aborption?

A

Through the mouth

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11
Q

Why is fentanyl absorbed orally?

A

It is lipophilic

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12
Q

Benefit of a fentanyl lolipop?

A

Quick way of getting drug into bloodstream

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13
Q

Examples of nonsteroidal anti inflammatory drugs?

A

Aspirin, ibuprofen, diclofenac, paracetamol

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14
Q

What effects do NSAIDs have?

A

Anti inflammatory, antipyretic, analgesic

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15
Q

Antipyretic meaning?

A

Decreases fever

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16
Q

What normal effect of NSAIDs can paracetamol not do?

A

Be anti-inflammatory

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17
Q

How do the additive properties of paracetamol and ibuprofen work?

A

The positive effects are additive but the toxic effects are not

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18
Q

Who cannot take paracetamol and ibuprofen?

A

Childeren

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19
Q

What do all NSAIDs inhibit?

A

Prostaglandins

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20
Q

What do prostaglandins activate?

A

Prostanoid receptors

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21
Q

What happens when prostanoid receptors are activated?

A

Sensitisation of nociceptors

22
Q

What is the first molecule in prostaglandin synthesis?

A

Phospholipids

23
Q

What are phospholipids converted to in prostaglandin synthesis?

A

Arachidonic acid

24
Q

What catalyses the formation of arachidonic acid from phospholipids?

A

Phospholipase a2

25
Q

What is arachidonic acid converted to in prostaglandin synthesis?

A

Prostaglandin H2

26
Q

What catalyses the formation of prostaglandin H2 in prostaglandin synthesis?

A

Cyclo-oxygenase-1 or -2 (COX-1 or COX-2)

27
Q

What is prostaglandin H2 converted to in prostaglandin synthesis?

A

Prostaglandin E2 (PGE2)

28
Q

What catalyses the formation of prostaglandin E2 in prostaglandin synthesis?

A

PGE synthase

29
Q

Which step of prostaglandin synthesis do NSAIDs target?

A

The conversion of arachidonic acid to prostaglandin H2

30
Q

How do NSAIDs inhibit prostaglandin synthesis?

A

They block COX-1 or COX-2

31
Q

Disadvantages of NSAIDs?

A

Severe gastric irritation, kidney disorders

32
Q

Where is COX-1 found?

A

Widespread throughout the body

33
Q

What is COX 2 exclusively involved in?

A

Inflammatory response

34
Q

Inhibition of which specific enzyme causes the desired effects of NSAIDs?

A

COX-2

35
Q

Inhibition of which specific enzyme in the prostaglandin synthesis pathway causes causes gastric irritation?

A

COX-1

36
Q

Which drugs are COX-2 inhibitors?

A

Rofecoxib (vioxx), Celecoxib (celebrex)

37
Q

Main issue with Rofecoxib (vioxx)?

A

Cardiac side effects

38
Q

Side effect occurrence in Rofecoxib (vioxx) patients?

A

1/10,000

39
Q

What is an example of a disease that taking Rofecoxib (vioxx) or celecoxib (celebrex) helps?

A

Rheumatoid arthritis

40
Q

What is neuropathic pain?

A

Pain unrelated to peripheral nociception

41
Q

What can cause neuropathic pain?

A

Peripheral nerve damage, peripheral nerve terminal damage or infection, spinal damage, thalamic stroke

42
Q

Issue with neuropathic pain?

A

Does not respond to opioids or NSAIDs

43
Q

Which drugs work for shingles pain?

A

Tricyclic antidepressants

44
Q

Example of a tricyclic antidepressant?

A

Imipramine

45
Q

Why, is it thought, that tricyclic antidepressants help with shingles pain?

A

They boost noradrenaline

46
Q

Which drugs can be useful in neuropathic main?

A

Antiepileptics (gabapentin), cannabinoid receptor agonists

47
Q

Which condition can cannabinoid receptor agonists be used to treat in the uk?

A

Multiple sclerosis

48
Q

Issues with glutamate receptor blockers (e.g. MK801)?

A

Side effects–> psychotic episode

49
Q

How do neurokinin receptors work?

A

Blocking central sensitisation

50
Q

Issue with analgesics that block centran sensitisation?

A

Would need to take them before any pain is going to occur, as central sensitisation has already occured after pain has been felt

SL22044 Neuroscience (34 decks)

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