Pain Management In Veterinary Medicine Flashcards

1
Q

What is the definition of pain?

A

“ PAIN is an unpleasant sensory and emotional experience associated with, or
resembling that associated with, actual or potential tissue damage

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2
Q

What is transduction?

A

Conversion of a noxious stimuli to an action potential at the level of the nociceptors

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3
Q

What is projection?

A

Nociceptive info transported into the brain

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4
Q

What is perception?

A

Brain’s process of integrating the nociceptive info or the conscious processing of pain

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5
Q

How would you classify acute pain?

A
  • Results of trauma, surgical or infectious events
  • Starts abruptly, resolves in days/weeks
  • Self-limiting, biological purpose
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6
Q

How would you classify chronic pain?

A
  • Persists beyond normal time of healing/absence of healing
  • > 1-3 months in duration
  • Disease
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7
Q

What is somatic pain?

A

Well localised, aching, sharp, intense
* Superficial or Deep

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8
Q

What is visceral pain?

A
  • Dull, diffused, poorly defined sensation
  • Referred pain
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9
Q

What is neuropathic pain?

A

Caused by injury of the somatosensory system (i.e., peripheral nerves, spinal cord or brain)

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10
Q

What is allodynia?

A

Pain sensation in response to a non painful stimulus

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11
Q

What is hyperalgesia?

A

Exagerated pain sensation in response to a normally painful stimulus

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12
Q

What is the facial pain scale?

A

Observation of the subject from a distance
* Different action units
*  No direct interaction
* Developed in many species

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13
Q

Why should we treat pain?

A

Avoiding
* stress reactions
* Delayed wound healing
* Inflammation
* Decreased appetite

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14
Q

What is pre-emptive analgesia?

A

Administration of analgesics drugs BEFORE the onset of the noxious stimulus
* Reason to administer analgesic drugs in premedication

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15
Q

What is multi-modal analgesia?

A

Use > than one pharmacological class of analgesic medications targeting different
receptors along the pain pathway
* Produce superior analgesia
* To reduce individual class-related side effects

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16
Q

What is tramadol?

A

Weak mu-receptor agonist
* Weak alpha 2 agonist action
* Inhibitor of norepinephrine & serotonin reuptake in the CNS
* NMDA receptor antagonism?
* Active metabolite minimal in dogs & cats after oral administration
* Analgesia?
* Serotonin Syndrome risk
* Vomiting, Drowsiness

17
Q

What is an alpha-2 adrenergic receptor?

A

Analgesia shorter lasting compared to sedation?
* Spinal (pre & post synaptic) & Supraspinal * Adjunctives : synergistic with opioids * Acute Pain * Side effects: Sedation, Bradycardia & Blood pressure changes, emesis

18
Q

What is ketamine?

A

Non- competitive NMDA receptor antagonist
* Interaction with many other
receptors (opioid, nicotinic &
muscarinic…)
*  Acute & Chronic pain

19
Q

What are the adverse effects of local anaesthetics?

A

Systemic toxicity (overdose, IV administration, species)
* Nerve & local tissue injury
* Local haemorrhage
* Infections
* Allergic reactions (preservatives, esters local anaesthetics)

20
Q

What does lidocaine do?

A

Blockage of Na+ channels
* Anthiarrhythmic (class 1B)
* Anti-inflammatory
* Promotion of gut motility
* Nausea & Vomiting

21
Q

What are the adverse effects of NSAIDS?

A

Vomiting, diarrhoea, anorexia, gastro-intestinal ulceration & perforation
* Renal injury
* Drug induced liver injury
* Coagulation

22
Q

What is paracetamol?

A

COX-3 inhibition (brain): antipyretic effect
* Acute & Chronic Pain
* Weak analgesic & anti-inflammatory
* Licensed (dogs) with codeine for up to 5 days
* Analgesic mechanism of action?
* Prostaglandins inhibition
* Serotoninergic pathway activation
* Endocannabinoids enhancement
* L arginine/NO pathway
* Opioid Mu receptor agonist

23
Q

What is the function of frunevetmab in cats/ bedinvetmab in dogs?

A

Inhibition of NGF mediated cell signalling to reduce pain
* Monthly subcutaneous injection
* Only licenced for treatment of PAIN associated with OA
* Contraindicated with NSAIDs (In humans)
* Allergic reaction, injection site reactions (dermatitis, alopecia, pruritus)

24
Q

What do you use gabapentin in association with?

A

Neuropathic pain/ seizures
* Acute pain??
* Blockage of Ca2+ channels presynaptic neurons →↓ Ca2+ influx→ ↓ excitatory
neurotransmitters
* Use in association with NSAIDs, opioids…
* Side effects: Sedation, ataxia, vomiting, diarrhoea, increased appetite

25
Q

What is amantadine?

A

Antagonist of N-methyl-D-aspartate (NMDA) receptors: blockage of pain
transmission
* Decrease central sensitization: long onset of action
* Chronic pain (in association with other analgesic drugs)
* Side effects: lethargy, gastro-intestinal upset, seizures

26
Q
A