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Anesthesiology > Pain in Animals > Flashcards

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
Q

What are causes of inflammatory pain?

A

Tissue trauma
Surgery, burns, injury
Nocicpetive pain

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26
Q

What is the cause of neuropathic pain?

A

Nerve injury

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27
Q

What are causes of somatic pain?

A 
Inflammatory pain (bone, muscle skin, peritoneum)
Sharp, stabbing, well localized
A-delta nociceptors
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28
Q

What are causes of visceral pain?

A

Distention, ischemia, smooth muscle spasm, stretching of ligaments
Dull, aching, radiate to other area
C fiber and A-delta fibers

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29
Q

What is the treatment for mild pain?

A

Responds to no or minimal drug prevention

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30
Q

What is the treatment for moderate severity?

A

Needs significant analgesic intervention; mulitmodal

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31
Q

Why treat pain?

A

Prevent or minimize suffering

Prevent pathologic consequences

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32
Q

What are signs of pain across all species?

A

Inappetence
Abnormal behavior
Abnormal posture
Facial expression

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33
Q

What are signs of pain in birds?

A

Reluctant to move
Ruffled feathers
Aggression
Feather picking

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34
Q

What are signs of pain in cattle?

A 
Grunt, bellow
Anti-social behavior
Decreased production
Painful expression
Bruxism
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35
Q

What are signs of pain in cats?

A 
Hide, reluctant to move
No grooming
Abnormal posture
Aggression
Tachycardia
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36
Q

What are signs of pain in dogs?

A

Reluctant to move
Growl or bite vocalize
Tremble, abnormal posture
Tachycardia

37
Q

What are signs of pain in goats, sheep, and llamas?

A

Bruxism
Reluctant to move
Grunt or bleat
Anti-social behavior

38
Q

What are signs of pain in horses?

A

Run, thrash, roll
Flare nostrils
Trachcradia
Tachypnea

39
Q

What are signs of pain in swine?

A

Anti-social behavior
Recumbency
Vocalization
Aggression

40
Q

How can you recognize pain?

A

Consider degree of pain
Watch from a slight distance
Examine vital signs (HR, RR)
Gently palpate wound area

41
Q

How can you manage pain?

A

Optimize comfort
Provide analgesics
Match degree and duration of analgesics with that of pain

42
Q

What are the goals of preemptive analgesia?

A

Prevent sensitization

Imrpove recovery

43
Q

What is preemptive analgesia?

A

Analgesic intervention prior to the application of a pinful stimulus

44
Q

What is preventive analgesia?

A

Analgesia provided beofre, during, and postoperatively to prevent nociception

45
Q

Describe IV administration

A

Immediate efficacy
Give slowly
Monitor vitals

46
Q

Describe CRI administration

A

Consistent drug plasma levels

More effective analgesia

47
Q

What drugs effect transduction?

A

NSAIDs
Opioids
Local anesthetics
Corticosteroids

48
Q

What drugs effect transmission?

A

Local anesthetics

Alpha 2-agonists

49
Q

What drugs effect modulation?

A 
Local anesthetics
NSAIDs
Opioids
Alpha 2-agonists
Ketamine
NMDA antagonists
50
Q

What drugs effect perception?

A

Opioids
Sedatives
General anesthetics

51
Q

What are the mainstays of opioids?

A

Acute pain management in small animals

52
Q

What are adjuncts of opioids?

A

Acute pain in large animals

53
Q

What is the mechanism of action of opioids?

A

Bind to opioid receptors

54
Q

What do opioids activate?

A

Antinociceptive neurons

55
Q

What do opioids inhibit?

A

Nociceptive neurotransmitters

56
Q

What do opioid mu receptors cause?

A 
Profound analgesia
Respiratory depression
Bradycardia
Sedation Euphoria
Dependence
Constipation
57
Q

What do opioid kappa receptors cause?

A

Analgesia
Mild sedation
Mild euphoria
Less likely to produce respiratory depression

58
Q

What do opioid delta receptors cause?

A

Analgesia
Respiratory depression
Dependence

59
Q

What is an opioid full agonist?

A

Binds to and activates all 3 receptor types; no ceiling effect

60
Q

What is an opioid partial agonist?

A

Activates some or all receptor types; ceiling effect

61
Q

What does an opioid agonist/antagonist do?

A

Binds to receptors, activates some, prevents activation of others

62
Q

What does an opioid antagonist do?

A

Binds to and prevents activation of receptors

63
Q

What are the desirable effects of opioids?

A

Analgesia

Sedation in dogs

64
Q

What are the adverse effects of opioids?

A

Bradycardia
Respiratory depression
Euphoria/dysphoria
Constipation, decreased GI motility

65
Q

What is the most common administration route of opioids?

A

Parenteral

66
Q

What do alpha-2 adrenergic agonists do?

A

Acute pain management in large animals

Effective in small animals

67
Q

What is the mechanism of alpha-2 agonists?

A

Bond to either presynaptic or postsynaptic receptors in the CNS or PNS
Actions can be excitatory or inhibitory

68
Q

Where can you find receptors for alpha-2 agonists?

A 
CNS
Blood vessels
Pancreas
Uterus
Bladder
Kidneys
Platelets
Bowel
69
Q

What are the desirable effects of alpha-2 agonists?

A

Analgesia
Sedation
Relaxation

70
Q

What are the adverse effects of alpha-2 agonists?

A 
Peripheral vasoconstriction
Bradycardia
Diuresis
Blood pressure changes
Pulmonary hypertension
Hypoxemia in sheep
Insulin inhibition
aggressive responses
71
Q

What are NSAIDs used for?

A

Large and small animals with chronic pain

Adjunctive for acute pain

72
Q

What is the mechanism of NSAIDs?

A

Inhibition of cyclooxygenaase enxyme

73
Q

What is the result of NSAIDs?

A

Decreased prostaglandin synthesis

74
Q

What is COX-1?

A

Constitutive from GI integrity
Platelet aggregation
Renal blood flow

75
Q

What is COX-2?

A

Inducible form activated in response to tissue damage

76
Q

What is the goal of NSAIDs?

A

Prevent COX-2 without affecting COX-1

77
Q

What is the problem with NSAIDs?

A

Veterinary species vary in COX activity

78
Q

What are the desirable effects of NSAIDs?

A

Analgesia
Anti-inflammatory
Anti-pyretic

79
Q

What are the adverse effects of NSAIDs?

A

GI ulceration
Decreased renal blood flow
Decreased platelet function
Hepatic toxicity

80
Q

What is the mechanism of lacal anesthetics?

A

Inhibition of nerve impulse transmission

Block sodium conduction through the nerve membrame ion channels

81
Q

What will require less drugs when using local anestheetics?

A

Small fibers
Fast nerve firing frequency
High tissue pH

82
Q

What are desirable effects of local anesthetics?

A

Loss of sensation

Temporary local anesthesia

83
Q

What are the adverse effects of local anesthetics?

A

Loss of motor function
Autonomic dysfunction
Toxicity

84
Q

What is the mechanism of NMDA antagonist?

A

Blockade of calcium channels in n-methyl-d-aspartate receptors

85
Q

What do NMDA antagonists do?

A

Mediate pain transmission in CNS

Involved in central sensitization

86
Q

What are the desired effects of NMDA antagonist?

A

Analgesia

Prevention or blockage of central sensitization

87
Q

What is the mechanism of corticosteroids?

A

Inhibitor of nuclear RNA synthesis

Blockage of phospholipase A- inhibition of prostaglandin synthesis

88
Q

What are the desired effects of corticosteroids?

A

Anti-inflammatory
Anti-pyretic
Analgesia

89
Q

What are the adverse effects of corticosteroids?

A

Inhibition of healing
Hyperadrenocorticism
Immunosuppression
GI ulceration

Anesthesiology (27 decks)

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