Pain lecture 3 Flashcards
Nociceptive pain is normally terminated by what?
-Healing and repair process
Where do you find the periacqueductal gray?
-Midbrain
What are the endogenous opioid peptides known as?
-Endorphins
What are the basic endorphins?
-Methionine and leucine known as enkephalins
What receptors do enkephalins work on?
-Mu and delta
What are most opioid drugs?
Mu opioid agonists
How many amino acids do you find in enkephalins?
5
Beta endorphins are made of how many amino acids?
-91
What do endorphins do?
-Increase dopamine release in our reward pathway
Dynorphins A and B react with with opioid receptor?
-Kappa with slight mu and delta interactions
How many amino acids make up dynoprhins?
-17
Do Dynorphins have addiction potential?
-No
What are dynorphins a big regulator of?
-Dopamine
Drugs that enhance the action of NE and 5HT have what type of effects?
-Anti nociceptive
Opioid analgesics act in what places?
Periacqueductal gray and dorsal horn
In the dorsal horn these Endogenous pain suppressants do what?
-Inhibit the release of pain transmitters
What are neuropathic pain features?
- Pain sensations may be continuous or periodic but occur without activation of nociceptors
- 1 or multiple peripheral nerves caused by damage to the nerves
What can cause neuropathic pain?
- Abnormal activity in nociceptive fibers
- Abnormal activity in central pain pathways
What are some examples of neuropathic pain?
- Phantom limb
- Diabetes neuropathies
- Shingles
- Trigeminal neuralgia
- Fibromyalgia
Do neuropathic pain treatments respond to NSAIDs?
-No
T/F Neuropathic pain treatment response inconsistently to opioids
True
Besides Opioids some people with neuropathic pain can respond to what other drugs?
- Antidepressants (Cymbalta)
- Anticonvulsants (Lyrica, Gabapentin)
- Corticosteroids
What are some possible mechanisms of neuropathic pain?
- 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
