Pain lecture 3

Question 1

Nociceptive pain is normally terminated by what?

Answer 1

-Healing and repair process

Question 2

Where do you find the periacqueductal gray?

Answer 2

-Midbrain

Question 3

What are the endogenous opioid peptides known as?

Answer 3

-Endorphins

Question 4

What are the basic endorphins?

Answer 4

-Methionine and leucine known as enkephalins

Question 5

What receptors do enkephalins work on?

Answer 5

-Mu and delta

Question 6

What are most opioid drugs?

Answer 6

Mu opioid agonists

Question 7

How many amino acids do you find in enkephalins?

Answer 7

5

Question 8

Beta endorphins are made of how many amino acids?

Answer 8

-91

Question 9

What do endorphins do?

Answer 9

-Increase dopamine release in our reward pathway

Question 10

Dynorphins A and B react with with opioid receptor?

Answer 10

-Kappa with slight mu and delta interactions

Question 11

How many amino acids make up dynoprhins?

Answer 11

-17

Question 12

Do Dynorphins have addiction potential?

Answer 12

-No

Question 13

What are dynorphins a big regulator of?

Answer 13

-Dopamine

Question 14

Drugs that enhance the action of NE and 5HT have what type of effects?

Answer 14

-Anti nociceptive

Question 15

Opioid analgesics act in what places?

Answer 15

Periacqueductal gray and dorsal horn

Question 16

In the dorsal horn these Endogenous pain suppressants do what?

Answer 16

-Inhibit the release of pain transmitters

Question 17

What are neuropathic pain features?

Answer 17

• Pain sensations may be continuous or periodic but occur without activation of nociceptors
• 1 or multiple peripheral nerves caused by damage to the nerves

Question 18

What can cause neuropathic pain?

Answer 18

• Abnormal activity in nociceptive fibers

- Abnormal activity in central pain pathways

Question 19

What are some examples of neuropathic pain?

Answer 19

• Phantom limb
• Diabetes neuropathies
• Shingles
• Trigeminal neuralgia
• Fibromyalgia

Question 20

Do neuropathic pain treatments respond to NSAIDs?

Answer 20

-No

Question 21

T/F Neuropathic pain treatment response inconsistently to opioids

Answer 21

True

Question 22

Besides Opioids some people with neuropathic pain can respond to what other drugs?

Answer 22

• Antidepressants (Cymbalta)
• Anticonvulsants (Lyrica, Gabapentin)
• Corticosteroids

Question 23

What are some possible mechanisms of neuropathic pain?

Answer 23

• Peripheral sensitization process may persist rather than subside
• Damaged nociceptive nerves may fire spontaneously
• Prolonged input from hyperexcitable nociceptive fibers
• Decreased activity of endogenous pain suppressant neural system