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Block 5 Week 2 Dani > Pain Correlates-Falkenberg TBL > Flashcards

Pain Correlates-Falkenberg TBL Flashcards

1
Q

Where do we find nociceptors?

A

skin, muscle, joints and visceral tissues

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2
Q

How do you get neuropathic pain?

A

primary lesion or dysfunction in the nervous system,

i.e diabetic neuropathy

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3
Q

What is sympathetic pain or CRPS?

A

Pain signals from the sympathetic nervous system become constant and severe, even though there is no obvious cause of pain. The mechanism by which this happens is complex and not fully understood.

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4
Q

What kind of pain is this:

relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown.

A

idiopathic

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5
Q

What makes the nervous system plastic?

A 
windup
change of neurotransmitter
change of phenotype
sprouting
glial cells
hyperesthesia
allodynia
hyperlgesia
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6
Q

What are first line analgesic drugs?

A

acetaminophen
aspiring/NSAIDs
adjuvants

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7
Q

What are 2nd line or drugs to use when pain is out of control drugs?

A

opoids (sustained release or immediate release)
NSAIDs
adjuvants

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8
Q

What drugs do use for refractory pain (pain that persists longer than usual and isnt responding to the usual meds)?

A 
spinal/epidural opoids (clonidine, local anesthetic)
selective nerve blocks
neuroablative procedures
Ketamine
total sedation
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9
Q

What are the major classes of analgesics?

A

NSAID’s
P-aminophenol
Opiates
Local anesthetics, lidocaine

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10
Q

What are examples of NSAIDS?

A

ibuprofen, naproxen, ketoprofen, COX-2 inhibitor

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11
Q

What is an example of an P-aminophenol?

A

tylenol

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12
Q

What are examples of opiates?

A

morphine, oxycodone, fentanyl

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13
Q

What is an excellent anesthetic?

A

lidocaine

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14
Q

What is a common calcium channel blocker?

A

ziconotide

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15
Q 
what are these:
Calcium channel blockers- ziconotide
Anticonvulsants
Selective serotonin reuptake inhibitors
Alpha-agonists
Multi-receptor drugs- Tapentadol (NE)
TRPV-1- antagonists
A

analgesics

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16
Q

What drugs target the cortex for pain relief?

A

anxiolytics, hypnotics, opoids, psychostimulants, anticonvulsants

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17
Q

What drugs target the thalamus for pain relief?

A

SSRI’s, anticonvulsants

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18
Q

What drugs target the spinal cord?

A

Opoids, adrenergicagonists, SSRIs.

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19
Q

Where do you put a neural blockade?

A

spinal cord baby!

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20
Q

What can illicit pain relief at the pain receptors?

A

NSAIDs

Local Anesthetics

21
Q

What does P.O stand for?

A

oral

22
Q

What does P.R stand for?

A

rectal

23
Q

What does Sub. Q stand for?

A

subcutaneous

24
Q

How do you give someone a transmucosal administration of a drug?

A

via a sublingual lollipop

25
Q

Why should you treat pain?

A

pulmonary function, CV function, mobility

26
Q

The majority of drugs are (blank) rather than local. Why are local drugs so nice?

A

systemic

Because they have less systemic effects so less side effects

27
Q

What is fentanyl?

A

100 X more potent than morphine (used in chronic pain patients)

28
Q

What is preemptive analgesia?

A

prevent firing of pain nerves prior to surgery to increase recovery time and decrease risk of chronic pain.
(hit them with that multimodality, and do it before, during and after to prevent wind up)

29
Q

What is additive and synergistic analgesia?

A

treating multiple types of receptors (multimodality) will have an additive affect and result in better pain relief

30
Q

What is on-demand analgesia?

A

when the patient asks for it and you give it to them

31
Q

What is patient controlled analgesia? What pnt population to you need to do special stuff for and why?

A

they have a button they can press for analgesia

children, keep parents out of room because the parents always mess with the button

32
Q

What should you do for chronic pain?

A

comprehensive history and workup , and treat the, with a multidisciplinary approach and the goal is to increase their function rather than relieve the pain

33
Q

What are adjuncts?

A

drugs that you can use on top of other drugs

34
Q

What are some pharmacological adjuncts?

A 
steroids
TCAs
muscle relaxants
nerve blocks
epidural injections
spinal injections
clonidine
anti-epileptic drugs
35
Q

If people are in pain will they get addicted to a drug?

A

no!!!! You can take a ton of it without getting addicted with pain BUT if you dont have pain and take a drug you can get addicted super fast

36
Q

What are some fears of narcotics?

A

addiction, abuse, side effects, legal issues

37
Q

How have drugs advanced so they cant be abused?

A

they have been made to be ineffective if crushed :)

38
Q

In general it takes (blank) half-lives to get to a therapeutic level

A

5

39
Q

How do you dose a drug based on weight?

A

mg/kg to the 3/4 power.

40
Q

How can you get immediately to the therapeutic range?

A

loading dose!

41
Q

If a drug gets approved by the FDA do you have to prescribe them for what the drug was intended for?

A

nope you can prescribe it for whatever you want

42
Q

What is a TRPV-1 receptor activator? What do they do?

A

adlea (capsaicin)

they desensitize the nociceptors (think ben gay)

43
Q

What does bicifadine do?

A

inhibits nor-epi and serotonin reuptake

44
Q

What does RTX (reseniferatoxin?

A

TRPV-1 agonist

45
Q

What works on glial cells?

A

CB2 (cannabinoid)

46
Q

What are intrathecal pumps?

A

an implantable device in the spine that allows for meds to get directly pumped into it

47
Q

What are dorsal column stimulators?

A

they are implantable devices in your spinal cord that will provide it with electrical stimulation to relieve pain

48
Q 
What are these:
Ganglion blocks, neurotoxic
Neurosurgical- ex. ganglionectomy, thalamotomy, nerve decompression, gamma knife
Surgical- sympathectomy
Radio-frequency treatments
Whats the issue with these?
A

other procedures for analgesia

sometimes can cause windup and result in worse pain

Block 5 Week 2 Dani (10 decks)

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