Pain Management Flashcards
What are the two broad categories of pain?
Acute and chronic
What is acute pain?
Pain that serves a protective function due to obvious tissue damage
What is chronic pain?
Pain that has extended beyond the period of healing and serves no purpose
What are the main types of pain?
Nociceptive
Neuropathic
What is nociceptive pain?
Appropriate physiological response to painful stimuli
What is neuropathic pain?
Inappropriate pain response due to nervous system dysfunction
Give some causes of neuropathic pain
Shingles
Surgery
Trauma
Diabetes
Give some examples of non-opioid analgesics
NSAIDs
Paracetamol
How do NSAIDs work?
Inhibit COX-1 causing prostaglandin synthesis to decrease
Give some side effects of NSAIDs
GI irritation
Renal toxicity
How does paracetamol work?
Inhibits central prostaglandin synthesis
What is the main side effect of paracetamol?
Toxic liver damage
Give examples of weak opioids
Tramadol
Codeine
Give examples of strong opioids
Morphine
Oxycodone
How do opioid analgesics work?
Activate the endogenous analgesic system to eliminate the subjective feeling of pain
Reduce ascending pain signal transmission in spinal cord
Give some side effects of opioid analgesics
Nausea
Vomiting
Constipation
Dizziness
What type of pain do opioid and non-opioid analgesics treat?
Nociceptive
What drug classes can be used to treat neuropathic pain?
Antidepressants (TCAs, SSRIs and SNRIs)
Anticonvulsants
Which are better analgesics - SNRIs or SSRIs?
SSRIs
Give examples of TCAs that can be used to treat neuropathic pain
Amitriptylline
Imipramine
How do TCAs work?
Inhibit neuronal reuptake of noradrenaline and serotonin
Give some side effects of TCAs
Constipation
Dry mouth
Tachycardia
Insomnia
Give examples of SSRIs and SNRIs
Duloxetine
Venlafaxine
Give some side effects of SSRIs
N + V
Constipation
Somnolence
Dry mouth
What anticonvulsants can be used to treat neuropathic pain?
Gabapentin
Pregabalin
Carbamazepine
Give some side effects of anticonvulsants
Sedation
Dizziness
Nausea
Peripheral oedema
Topical analgesics reduce pain transmission by which fibres?
A delta fibres
C fibres