Pain Control & Anesthetic Drugs (Overview) Flashcards
T/F: Analgesics causes loss of consciousness
False
Anesthetics do this. Analgesia is pain relief without loss of consciousness and without total loss of feeling or movement.
T/F: NSAIDs are more effective if taken before pain.
True
T/F: NSAIDs can be used as analgesics for broken bones
False
NSAIDS block the formation of pain mediators in peripheral NS. They do not produce sufficient analgesia to counteract severe pain that is associated with broken bones.
T/F: NSAIDs are commonly used for patients with osteoarthritis.
True
T/F: Reversal agents for opioids active opioid receptors.
False
they bind to the receptor but DO NOT activate it.
What are the 5 pillars of pain?
Heat Redness Swelling Pain Loss of Function
When would you use an Opioid over an NSAID? Why?
If you need strong pain relief
b/c opioids work at the brain regardless of # of signals being sent to the brain, while NSAIDs and steroids only decrease the # of pain signals being sent to the brain
What are the 4 parts of the nociceptive pathway?
Transduction
Transmission
Modulation
Perception
Def. transduction
stimulus of a nociceptor that converts physical trauma to a nerve signal
Def. transmission
the impulse is sent up sensory nerves to the spinal cord
Def. Modulation
sensory impulses in spinal cord are either inhibited or amplifed
Def. Perception
sensory impulse arrives in the brain and is perceived as pain
What part of the arachidonic pathway will NSAIDs inhibit?
NSAIDs inhibit COX and LOX from acting on arachidonic acid. This prevents arachidonic acid from being trnasformed into PGs, Thromboxanes, and Leukotrienes
What part of the arachidonic pathway will corticosteroids inhibit?
Inhibits phospholipase A2
Which COX is which?
Compare COX-1 to COX-2.
COX-1 = good enzyme
-produces PGs involved in normal physiological processes and is normally always present in different systems throughout the body
COX-2 = bad enzyme
-produces PGs that are primarily involved with physiological changes associated with inflammation
Why is the amount of protein in the bloodstream important when talking about NSAIDs and their power?
NSAIDs bind to proteins in the bloodstream, and when they do that they stay in the bloodstream in higher concentration. When there are fewer proteins for them to bind to, then the NSAID will slip out of the capillary and you won’t have as high a drug concentration.
What conditions can cause hypoproteinemia?
- Liver disease (b/c the liver produces proteins)
- Enteropathy (GI Dz, where the protein leaks into the bowel
- Nephropathy (renal Dz, where the protein leaks out in the urine)
Differentiate between classic NSAIDs and “COXIBs”
- Classic NSAIDs are not COX specific, so they bind to COX 1 & COX 2
- COXIBs are “selected COX-2 inhibitors” meaning they target primarily COX-2
What side effects can be seen when COX-1 is targeted?
- decreased mucus production
- decreased GI tissue perfusion
- decreased cell turnover
- increased acid production as a result
List 3 classic NSAIDs
Aspirin
Flunixin Meglumaine (banamine)
Phenylbutazone
