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Pain in Animals Flashcards

1
Q

What is pain?

A

Unpleasant emotional and sensory experience from actual or potential tissue damage

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2
Q

What is a nociceptor?

A

A pain receptor with free nerve ending of primary sensory neurons; A-delta or C fiber

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3
Q

What is nociception?

A

Activation of nociceptors by noxious stimuli

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4
Q

What is analgesia?

A

The absence of pain in the presence of stimuli that would normally be painful

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5
Q

What are analgesics?

A

Drugs that produce analgesia

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6
Q

What is allodynia?

A

A painful response to a nonpainful stimulus

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7
Q

What is hyperalgesia?

A

An abnormally heightened sensitivity to pain

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8
Q

What is hypoalgesia?

A

A decreased sensitivity to painful stimulation

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9
Q

What is a neurotransmitter?

A

A substance released from a nerve ending, binds to a receptor, and causes a response

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10
Q

Does pain occur quickly or slowly with A-delta fibers?

A

Fast

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11
Q

Does pain occur quickly or slowly with C fibers?

A

Slow

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12
Q

What is the pathophysiology of pain?

A

Nociceptor activation

Tissue trauma causing a release of inflammatory mediators

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13
Q

What are the steps of pain processing?

A 
Transduction
Transmission
Modulation
Perception
Projection
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14
Q

What is transduction?

A

The process that involves the translation of a noxious stimulus into electrical signals at the sensory nerve ending

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15
Q

What is transmission?

A

The process of sending sensory impulses from the peripheral pain receptors to the spinal cord

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16
Q

What is projection?

A

Signals reaching the dorsal horn of the spinal cord synapse in laminae I, II, and V, then may or may not cross the spinal cord and continue to travel along second order neurons to higher areas of the CNS
A number of excitatory and inhibitory neurotransmitters are responsible for affecting signal transmission

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17
Q

What is modulation?

A

The modification of nociceptive transmission

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18
Q

What is perception?

A

Occurs once the transmitted signals reach the higher centers of CNS
Integration, processing, and recognition occurs

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19
Q

Why is pain difficult to manage?

A

Neurons exhibit plasticity

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20
Q

What are characteristics nociceptors acquire in the presence of inflammation?

A

Begin to discharge spontaneously
Threshold for activation is decreased
Decreased stimulus require to produce a response

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21
Q

What is the neurotransmitter released from C-fibers?

A

Glutamate

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22
Q

What does glutamate do?

A

Acts on NMDA receptors causing a change in the post-synaptic neuron causing it to respond more strongly to all input

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23
Q

What is acute pain?

A

< 2 weeks duration

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24
Q

What causes chronic pain?

A

Plasticity/sensitizaton

Arthritis, cancer, neuropathic

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25
What are causes of inflammatory pain?
Tissue trauma Surgery, burns, injury Nocicpetive pain
26
What is the cause of neuropathic pain?
Nerve injury
27
What are causes of somatic pain?
``` Inflammatory pain (bone, muscle skin, peritoneum) Sharp, stabbing, well localized A-delta nociceptors ```
28
What are causes of visceral pain?
Distention, ischemia, smooth muscle spasm, stretching of ligaments Dull, aching, radiate to other area C fiber and A-delta fibers
29
What is the treatment for mild pain?
Responds to no or minimal drug prevention
30
What is the treatment for moderate severity?
Needs significant analgesic intervention; mulitmodal
31
Why treat pain?
Prevent or minimize suffering | Prevent pathologic consequences
32
What are signs of pain across all species?
Inappetence Abnormal behavior Abnormal posture Facial expression
33
What are signs of pain in birds?
Reluctant to move Ruffled feathers Aggression Feather picking
34
What are signs of pain in cattle?
``` Grunt, bellow Anti-social behavior Decreased production Painful expression Bruxism ```
35
What are signs of pain in cats?
``` Hide, reluctant to move No grooming Abnormal posture Aggression Tachycardia ```
36
What are signs of pain in dogs?
Reluctant to move Growl or bite vocalize Tremble, abnormal posture Tachycardia
37
What are signs of pain in goats, sheep, and llamas?
Bruxism Reluctant to move Grunt or bleat Anti-social behavior
38
What are signs of pain in horses?
Run, thrash, roll Flare nostrils Trachcradia Tachypnea
39
What are signs of pain in swine?
Anti-social behavior Recumbency Vocalization Aggression
40
How can you recognize pain?
Consider degree of pain Watch from a slight distance Examine vital signs (HR, RR) Gently palpate wound area
41
How can you manage pain?
Optimize comfort Provide analgesics Match degree and duration of analgesics with that of pain
42
What are the goals of preemptive analgesia?
Prevent sensitization | Imrpove recovery
43
What is preemptive analgesia?
Analgesic intervention prior to the application of a pinful stimulus
44
What is preventive analgesia?
Analgesia provided beofre, during, and postoperatively to prevent nociception
45
Describe IV administration
Immediate efficacy Give slowly Monitor vitals
46
Describe CRI administration
Consistent drug plasma levels | More effective analgesia
47
What drugs effect transduction?
NSAIDs Opioids Local anesthetics Corticosteroids
48
What drugs effect transmission?
Local anesthetics | Alpha 2-agonists
49
What drugs effect modulation?
``` Local anesthetics NSAIDs Opioids Alpha 2-agonists Ketamine NMDA antagonists ```
50
What drugs effect perception?
Opioids Sedatives General anesthetics
51
What are the mainstays of opioids?
Acute pain management in small animals
52
What are adjuncts of opioids?
Acute pain in large animals
53
What is the mechanism of action of opioids?
Bind to opioid receptors
54
What do opioids activate?
Antinociceptive neurons
55
What do opioids inhibit?
Nociceptive neurotransmitters
56
What do opioid mu receptors cause?
``` Profound analgesia Respiratory depression Bradycardia Sedation Euphoria Dependence Constipation ```
57
What do opioid kappa receptors cause?
Analgesia Mild sedation Mild euphoria Less likely to produce respiratory depression
58
What do opioid delta receptors cause?
Analgesia Respiratory depression Dependence
59
What is an opioid full agonist?
Binds to and activates all 3 receptor types; no ceiling effect
60
What is an opioid partial agonist?
Activates some or all receptor types; ceiling effect
61
What does an opioid agonist/antagonist do?
Binds to receptors, activates some, prevents activation of others
62
What does an opioid antagonist do?
Binds to and prevents activation of receptors
63
What are the desirable effects of opioids?
Analgesia | Sedation in dogs
64
What are the adverse effects of opioids?
Bradycardia Respiratory depression Euphoria/dysphoria Constipation, decreased GI motility
65
What is the most common administration route of opioids?
Parenteral
66
What do alpha-2 adrenergic agonists do?
Acute pain management in large animals | Effective in small animals
67
What is the mechanism of alpha-2 agonists?
Bond to either presynaptic or postsynaptic receptors in the CNS or PNS Actions can be excitatory or inhibitory
68
Where can you find receptors for alpha-2 agonists?
``` CNS Blood vessels Pancreas Uterus Bladder Kidneys Platelets Bowel ```
69
What are the desirable effects of alpha-2 agonists?
Analgesia Sedation Relaxation
70
What are the adverse effects of alpha-2 agonists?
``` Peripheral vasoconstriction Bradycardia Diuresis Blood pressure changes Pulmonary hypertension Hypoxemia in sheep Insulin inhibition aggressive responses ```
71
What are NSAIDs used for?
Large and small animals with chronic pain | Adjunctive for acute pain
72
What is the mechanism of NSAIDs?
Inhibition of cyclooxygenaase enxyme
73
What is the result of NSAIDs?
Decreased prostaglandin synthesis
74
What is COX-1?
Constitutive from GI integrity Platelet aggregation Renal blood flow
75
What is COX-2?
Inducible form activated in response to tissue damage
76
What is the goal of NSAIDs?
Prevent COX-2 without affecting COX-1
77
What is the problem with NSAIDs?
Veterinary species vary in COX activity
78
What are the desirable effects of NSAIDs?
Analgesia Anti-inflammatory Anti-pyretic
79
What are the adverse effects of NSAIDs?
GI ulceration Decreased renal blood flow Decreased platelet function Hepatic toxicity
80
What is the mechanism of lacal anesthetics?
Inhibition of nerve impulse transmission | Block sodium conduction through the nerve membrame ion channels
81
What will require less drugs when using local anestheetics?
Small fibers Fast nerve firing frequency High tissue pH
82
What are desirable effects of local anesthetics?
Loss of sensation | Temporary local anesthesia
83
What are the adverse effects of local anesthetics?
Loss of motor function Autonomic dysfunction Toxicity
84
What is the mechanism of NMDA antagonist?
Blockade of calcium channels in n-methyl-d-aspartate receptors
85
What do NMDA antagonists do?
Mediate pain transmission in CNS | Involved in central sensitization
86
What are the desired effects of NMDA antagonist?
Analgesia | Prevention or blockage of central sensitization
87
What is the mechanism of corticosteroids?
Inhibitor of nuclear RNA synthesis | Blockage of phospholipase A- inhibition of prostaglandin synthesis
88
What are the desired effects of corticosteroids?
Anti-inflammatory Anti-pyretic Analgesia
89
What are the adverse effects of corticosteroids?
Inhibition of healing Hyperadrenocorticism Immunosuppression GI ulceration

Anesthesiology (27 decks)

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