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Clinical Neurology > Pain Management > Flashcards

Pain Management Flashcards

1
Q

What are the two broad categories of pain?

A

Acute and chronic

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2
Q

What is acute pain?

A

Pain that serves a protective function due to obvious tissue damage

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3
Q

What is chronic pain?

A

Pain that has extended beyond the period of healing and serves no purpose

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4
Q

What are the main types of pain?

A

Nociceptive

Neuropathic

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5
Q

What is nociceptive pain?

A

Appropriate physiological response to painful stimuli

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6
Q

What is neuropathic pain?

A

Inappropriate pain response due to nervous system dysfunction

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7
Q

Give some causes of neuropathic pain

A

Shingles
Surgery
Trauma
Diabetes

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8
Q

Give some examples of non-opioid analgesics

A

NSAIDs

Paracetamol

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9
Q

How do NSAIDs work?

A

Inhibit COX-1 causing prostaglandin synthesis to decrease

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10
Q

Give some side effects of NSAIDs

A

GI irritation

Renal toxicity

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11
Q

How does paracetamol work?

A

Inhibits central prostaglandin synthesis

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12
Q

What is the main side effect of paracetamol?

A

Toxic liver damage

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13
Q

Give examples of weak opioids

A

Tramadol

Codeine

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14
Q

Give examples of strong opioids

A

Morphine

Oxycodone

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15
Q

How do opioid analgesics work?

A

Activate the endogenous analgesic system to eliminate the subjective feeling of pain
Reduce ascending pain signal transmission in spinal cord

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16
Q

Give some side effects of opioid analgesics

A

Nausea
Vomiting
Constipation
Dizziness

17
Q

What type of pain do opioid and non-opioid analgesics treat?

A

Nociceptive

18
Q

What drug classes can be used to treat neuropathic pain?

A

Antidepressants (TCAs, SSRIs and SNRIs)

Anticonvulsants

19
Q

Which are better analgesics - SNRIs or SSRIs?

20
Q

Give examples of TCAs that can be used to treat neuropathic pain

A

Amitriptylline

Imipramine

21
Q

How do TCAs work?

A

Inhibit neuronal reuptake of noradrenaline and serotonin

22
Q

Give some side effects of TCAs

A

Constipation
Dry mouth
Tachycardia
Insomnia

23
Q

Give examples of SSRIs and SNRIs

A

Duloxetine

Venlafaxine

24
Q

Give some side effects of SSRIs

A

N + V
Constipation
Somnolence
Dry mouth

25
Q

What anticonvulsants can be used to treat neuropathic pain?

A

Gabapentin
Pregabalin
Carbamazepine

26
Q

Give some side effects of anticonvulsants

A

Sedation
Dizziness
Nausea
Peripheral oedema

27
Q

Topical analgesics reduce pain transmission by which fibres?

A

A delta fibres

C fibres

Clinical Neurology (20 decks)

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