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Neurology year 3 > PAIN and its management > Flashcards

PAIN and its management Flashcards

1
Q

describe acute pain

A

there is usually obvious damage
protective function
increased NS activity
pain resolves on healing

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2
Q

describe chronic pain?

A

when there is pain beyond expected period of healing

when pain no longer has a useful purpose

degrades function and health

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3
Q

name 2 types of pain

A

nociceptive

neuropathic

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4
Q

what is nociceptive pain?

A

an appropriate response to painful stimuli

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5
Q

what is neuropathic pain?

A

an inappropriate response caused by a dysfunction in NS

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6
Q

pain from something that normally isnt painful?

A

allodynia

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7
Q

more pain than expected from something?

A

hyperalgesia

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8
Q

name some causes of neuropathic pain?

A 
shingles
surgery
trauma
diabetic neuropathy
amputation
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9
Q

bad effects of NSAIDS

A

GI bleed
renal toxicity
CVS side effects

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10
Q

what is bad about paracetamol

A

toxic to liver

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11
Q

bad side effects of opiods?

A 
nausea and vomiting
constipation
dizzy
itch
dry skin
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12
Q

bad effects of tricyclic antideprressants?

A

constipation
insomnia
increased appetite
change in HR

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13
Q

bad effects of SSRIs?

A 
nausea and vomiting
constipation
dry mouth
increased sweat
decreased appetite
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14
Q

bad effects of anti convulsants e.g gabepentin

A 
sedation
dizzy
atxia
peripheral oedeama
nausea
weight gain
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15
Q

how does nociceptive pain begin?

A

by the activation of nociceptors- these are first order afferent neurones which are activated by intense or damaging stimuli. the cell bodies are located in the dorsal root ganglion

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16
Q

name the types of nociceptors?

A

C fibres- slow pain

Aδ fibres- fast pain

17
Q

what type of nociceptor is not myleinated?

A

C fibre

18
Q

what are the subtypes of Aδ fibre?

A

Type 1- high threshold mechanoreceptors- need strong mechanical stimuli for activation or temp >53- mediate first pain to mechanical stimuli

Type 2- respond to heat (43-47)- mediate first pain to heat

19
Q

what are the subclasses of C fibres?

A 
C-MH= respond to mechanical stimuli and heat, sensitive to capsain and prolonged stimuli
C-M= respond to mechanical stimuli
C-H= respond to noxious heat stimuli
C-MiHi= normally not sensitive to either. acquires sensitivity by inflammatory mediators
20
Q

where are primary afferent cell bodies located?

A

dorsal root ganglion

21
Q

where do the axons of primary afferents terminate?

A

in dorsal horn of spinal cord in various laminae of REDEX

22
Q

what is visceral pain from?

A

nociceptors on organs

23
Q

what is referred pain?

A

when the brain interprets the pain from the viscera from an area of skin that is distant to the original organ

24
Q

what are the 2 nociceptive tracts?

A

spinothalamic tract- fast pathway

spinoreticular path- largely transmits C fibre pain (slow pathway)

25
Q

what does this describe?

the nerve impulse evoked by injury are influenced in the spinal cord by other nerve cells that act like gates, either preventing the impulses from getting through, or by helping them

A

gate control theory

26
Q

things that might open the gates?

A 
of C/A fibres are active
bad injury
not enough meds
anxiety /stress/ fear
introvert
27
Q

opiate -what is it?

A

substances extracted from opium

28
Q

opiod- what is it?

A

any agent that acts upon opiod receptors

29
Q

what are the 3 opiod receptors?

A

mu- responsilbe for most analgesic activity
delta
kuppa

30
Q

is morphine an agonist and when is it used?

A

agonist

used in acute and chronic pain

31
Q

when is diamorphine used?

A

can be used post op in the UK

also an agonist

32
Q

what is Fentanyl used for?

A

maintenance of anaesthesia

(also an agonist)

33
Q

when is codeine used?

A

it is a weaker opiode so used for mild-moderate pain

taken orally

34
Q

what analgesic should be avoided in epilepsy?

A

tramadol

Neurology year 3 (30 decks)

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