Pain and Inflammation Flashcards
What is Pain?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
What are the ways of classifying pain?
Region of the body involved System with the dysfunction Duration and pattern of occurence Intensity and time since onset Etiology
What are the two types of pain?
Nociceptive pain
Pathological Pain
What is Nociceptive Pain?
It can be acute or chronic,
due to inflammation
What is Pathological Pain?
It is usually chronic
Can be due to damage of nervous tissues or Abnormal Function of systems
What are examples of neuropathic pain?
Neuralgia, Phantom Pain, Diabetic Neuropathy
What are examples of abnormal function pain?
Irritable Bowel Syndrome, Tension Headache
What does the pain cause?
Delay Healing Decreased appetite Increased stress Disrupts sleep Causes anxiety and depression
In diseases with chronic pain such as cancer, trigeminal neuralgia, post herpetic neuralgia, chronic inflammation, What drugs are usually given?
NSAIDS, Opioids
What are given to patients with psychogenic pain?
Anti-depressants
What are given for Severe Pain such as Post operative pain?
NSAIDS, Opioids
What are some chemical mediators of inflammation?
Histamine Bradikinin and Hydroxyptamine Prostaglandins/ Prostanoids Leukotrienes TNF alpha, IL-1
What are the mediator macrophages in Acute inflammation?
Mast Cell products (histamine)
Bradykinin
Lysosomal Components
Complement Lipid Mediators
What are teh mediator macrophages in Chronic Inflammation?
T-Lymphocytes and products Cytokines Growth Factor's Proteases and ROS Complement Lipid Mediators
What is the main mediator of Acute inflammation?
Prostaglandin
What is the main mediator of Chronic Inflammation?
T-Lymphocytes, Cytokines
What are the pre-inflammatory Amine mediators?
Histamine, Bradykinin
What are the Anti-inflammatory Amine mediators?
Adrenaline, Noradrenaline
What are the Pre-inflammatory Lipid Mediators?
PGE2, PGI2, LTB4, LTC4
What are the Anti-inflammatory Lipid Mediators?
PGI2, PGA2, Lipoxins
What are the Compliment Pre-inflammatory mediators?
C3a, C5a
What are the Compliment Anti-inflammatory mediators?
Clq Receptor
What are the Pre-Inflammatory Cyclic Nucleosides?
cGMP
What are the Anti-Inflammatory Cyclic Nucleosides?
cAMP
What are the Pre-Inflammatory Adhesion Molecules?
E-Selectin, P-Selectin, ICAM1, VCAM1
What are the Anti-Inflammatory Adhesion Molecules?
a2b2 Integrin, TSP Receptor, PS receptor
What are Pre-inflammatory Cytokines?
TNF, IL-1B, IL-5
What are Anti-inflammatory Cytokines?
TGF-B1, IL-10
What are Pre-inflammatory Chemokines?
IL-8, GRO/KC, MIP1a (CCL3), MCP1 (CCL2)
What are Anti-inflammatory chemokines?
NONE
What are Pre-inflammatory Steroid Hormones?
NONE
What are Anti-Inflammatory Steroid Hormones?
Glucocorticoids
What is the action of COX?
it acts on the Arachidonic Pathway to produce Prostaglandins
In normal condition, what are the dominant prostaglandins that are produced for protective purposes?
Prostacyclins such as PGI2, PGE2, Thromboxane
In Inflammatory condition, what metabolites are formed in prostaglandin synthesis?
There is exaggeration of PGE2 and prostacyclins
What is the function of PGD2?
Vasodilation
What is the function of PGE2, EP1?
Bronchoconstriction
GIT smooth muscle contraction
What is the function of PGE2, EP2?
Bronchodilation
GIT smooth muscle relaxation
Vasodilation
Pain
What is the function of PGE2, EP3?
Decreased Gastric Acid Secretion Increased Gastric Mucus Secretion GIT Smooth Muscle Contraction Uterine Contraction Lipolysis Inhibition Increase Autonomic neurotransmitters, pyresis
What is the function of PGF2A?
Uterine Contraction, Bronchoconstriction, Decreased IOP
What is the function of PGI2/ Prostacyclin?
Vasodilation Inhibits Platelet Aggregation Bronchodilation Salt Excretion Renal Blood Flow
What is the function of TXA2?
Vasoconstriction
Stimulates platelet aggregation
Bronchoconstriction
Decrease Renal Blood Flow and Salt Excretion
What are the general functions of Prostaglandins?
Constriction and dilation in vascular smooth muscle cells
Stimulates and inhibits Platelet aggregation
Acts on Parietal Cells in the stomach to inhibit acid secretion
Acts on mesangial cells in the glomerulus to increase GFR
Induces Labor
Decreases Intraocular Pressure
Regulates Hormones
Controls Cell Growth
Regulates Inflammation
Sensitizes Spinal Neurons to Pain
Regulates Calcium Movement
Acts on thermoregulatory center in hypothalamus to produce fever
What are the Medical Managements for Inflammation?
NSAIDs, Corticosteroids, Herbal