Pain and Inflammation Cards

Question 1

Used to relieve pain without significantly disturbing consciousness or altering actions of sensory nerves.

Answer 1

Analgesics.

Question 2

Used to reduce fever.

Answer 2

Antipyretics.

Question 3

What is the role of opiods?

Answer 3

To bind with opiate receptors in the brain and spinal column to inhibit tramsmission of pain impulses.

Question 4

What are endogenous opiods?

Answer 4

All have analgesia roles, some are released from the hypothalamus and brainstem while others are release into circulation from he pituitary, various receptors widely distributed throughout CNS, play roles in sexual behavior, euhoria, appetite, stress response, depression.

Question 5

What are the uses of morphine?

Answer 5

Management of all types of moderate to severe pain. Derivatives are used for cough inhibition, treatment of GI pain, relieving pain of myocardial infarction.

Question 6

What are some common and serious adverse effects of opioids?

Answer 6

Common: nausea, vomiting, dry mouth, constipation, itching, sedation. Serious: respiratory depression, confusion, hallucinations. Physical and psychological dependence may also occur.

Question 7

What is Methadone and what is it used for?

Answer 7

Is a synthetic opioid analgesic used for relief of moderate to severe pain. Is also used for heroin addicts and decreases heroin withdrawal symptoms and blocks euphoria effect.

Question 8

What is the role of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Answer 8

To relieve pain associated with acutely painful conditions such as arthritis or injury/sprain, dysmenorrhea, headaches and fever.

Question 9

What is the mechanism of action of NSAIDs?

Answer 9

Blocks prostaglandin synthesis by inhibiting cyclooxygenase enzymes (Cox 1 and Cox 2 enzymes)

Question 10

What are the adverse effects of NSAIDs?

Answer 10

Dyspepsia, nausea/vomiting, ulcers, easy bruising, occult bleeding, renal adverse drug reactions, hypertension, edema, negative effects on fetus in 3rd trimester.

Question 11

What is the mechanism of action of acetamipnophen?

Answer 11

Little anti inflammatory activity. Has no anti platelet activity (little bleeding side effects). Inhibits priostaglandin synthesis, but also affects cannabinoid receptor systems (appetite, pain-sensation, mood and memory).

Question 12

What are the uses of acetaminophen?

Answer 12

Treatment of musculoskeletal pain, headache, dysmenorrhea, myalgias neuralgias, arthritic and rheumatic conditions, reducing fever and discomfort of the common cold and viral infections. May caused LV and KD toxicity problems.

Question 13

What do pyrogens and prostaglandins affect?

Answer 13

Pyrogens induce prostaglandin release. PGE2 releases in the hypothalamus neurons to increase body temperature. There is an increase in sympathetic output, the thyroid hormone thermostat adjustment, perception of temperature changes and heat seeking behaviour begins, muscle tone induces shivering, vasoconstriction. NSAIDs and Acetominophen and COX2 inhibitors inhibit PGE2 synthesis to decrease fever.

Question 14

What are bradykinins?

Answer 14

Are peptide precursors in plasma and tissues which are activated by enzyme systems released by tissue damage.

Question 15

What are the effects of bradykinin?

Answer 15

Is a potent vasodilator (hypotension), increases vascular permiability, increased cardiac contractility, increases contraction of non vascular smooth muscle and bronchoconstriction.

Question 16

What inactivates bradykinin?

Answer 16

Inactivated by ACE (angiotensin converting enzyme).

Question 17

Where are the highest concentrations of mast cells?

Answer 17

Nose, mouth, feet, internal body surfaces and blood vessels.

Question 18

What are the functions of histamine?

Answer 18

Inflammation and immune regulator, stomach acid regulation, CNS roles, and sexual function.

Question 19

What is the Histamine 1 receptor’s targets tissue and actions?

Answer 19

Smooth muscle, endothelium and CNS; vasodialtion, bronchoconstriction and allergic response?

Question 20

What is the Histamine 2 receptor’s targets tissue and actions?

Answer 20

Stomach parietal cells; increase acid secretion.

Question 21

What is the Histamine 3 receptor’s targets tissue and actions?

Answer 21

CNS; inhibition of dopamine, GABA, Ach, noradrenaline and serotonine

Question 22

What is the Histamine 4 receptor’s targets tissue and actions?

Answer 22

Bone marrow, WBC thymus, liver, intestines, spleen and lung; chemotaxis and mast cell mobilization.

Question 23

What are antihistamines?

Answer 23

Block most, but not all, effects of histamine. First generation antihistamines bind non selectively to central and peripheral receptors and may result in CNS stimulation or depression. Have additional antipruritic or antienetic effects. Second generation antihistamines are selective for peripheral H1 receptors and as a group are less sedating.

Question 24

What are the uses of antihistamines?

Answer 24

Allergies, Parkinson’ disease, nausea and vomiting, and sedation.

Question 25

What are adverse reactions of antihistamines?

Answer 25

CNS reactions of drowsiness, sedation, or disturbed coordination. Anticholiergic effects of dryness of mouth, nose and throat and thickening of bronchial secretions.

Question 26

What are glucocoticoids (cortisol)?

Answer 26

Are made from cholesterol and released from the adrenals. Regulate stress, immunity, inflammation, metabolism, electrolytes and behavior. Are used to treat chronic pain or inflammation, or major physiological trauma.

Question 27

What are the pharmacodynamics of cortisol?

Answer 27

Affect DNA transcription of many cell types, cause major changes in cells regarding their structure, metabolism, intracellular and extracellular receptors and longevity.

Question 28

What are the pharmacokinetics of Cortisol?

Answer 28

70 pecent bioavailability through oral absorption, moves readily into all tisuues and intracellularrly where it has effects on DNA transcription in the nucleus, metabolized by the liver and excreted by the kidney. Half life of 3-4 hours. Specific steroid binding sites on albumin. The effects may last weeks.