PBL 2 - Aches And Pains Flashcards
Ibuprofen
NSAID
- Inhibits COX1 and COX2 (make prostaglandins)
- Can cross BBB to reduce prostaglandin E2
Diclofenac (5)
- NSAID
- Treat moderate to severe pain
- Inhibit formation of prostaglandins by blocking COX1 & COX2
- Inhibit the production of leukotrienes by inhibiting lipoxygenase
- Prescribed for musculoskeletal pain
Tramadol
- Opioid agonist
- Binds to μ-opioid receptor
- inhibits the reuptake of serotonin and noradrenaline
Amitriptyline (3)
- TCA antidepressant
- Prevention of migraines
- Treat neuropathic pain as anti-inflammatory effects
- SSRI & SNRI reuptake inhibitor
Pregabaline (4)
- Treat epilepsy, neuropathic pain, fibromyalgia and generalised anxiety disorder
- Ion channel modulator that has rapid analgesic, anticonvulsant and anxiolytic effects
- Binds to a2 subunit of calcium channel - increases decarboxylase and blocks glutamate
- SE: dizziness, addiction
Blocking which COX gives you acid corrosion of stomach?
COX2
Don’t give Diclofenac to … (3)
People with increased risk of heart attack
Or ischaemic heart disease
Or peripheral artery disease
Acupuncture works by (2)
Activating nociceptors - pain blocks pain (or inhibition blocks inhibition)
Activate a-beta fibres - GABA and enkephalin release, which results in both presynaptic, and postsynaptic nociceptor inhibition (from C fibres)
Paracetamol (4)
acetaminophen
- antipyretic and analgesic
- Reduces COX2
- Acts on endogenous cannabinoid system
Why doesn’t morphine work in tx neuropathic pain?
Nerve damage
Indigenous peptides CCK and receptors are up regulated by primary afferents and block action of morphine
Slipped disc in scenario is at ..
L5
Chronic pain lasts longer than …
12 weeks
Allodynia
Pain in response to innocuous stimulus
Hyperalgesia
Increased pain in response to painful stimuli
Superior parietal cortex - made of (2)
Controls (1)
Amygdala ad insula
Controls intensity of emotion
