Pharmacology Flashcards
Is Nociceptive pain adaptive or maladaptive?
Adaptive
Is Inflammatory pain adaptive or maladaptive?
Adaptive
Is Pathological pain adaptive or maladaptive?
Maladaptive
What are Nociceptors?
Specific peripheral primary sensory afferent neurones normally activated preferentially by intense stimuli (e.g. thermal, mechanical, chemical) that are noxious
How do nociceptors work?
They are first order neurones that send information to second order neurones in the CNS by chemical synaptic transmission
What is nociceptive pain meant for?
early warning system and to make memories to avoid harm in the future.
What is inflammatory pain caused by?
by the immune system in injury, or infection
How does inflammatory pain help healing of a body part?
discourages physical contact and discourages movement.
What protective function does pathological pain have?
None
What disorder results in not being able to feel pain?
Congenital Insensitivity to Pain (CIP)
How does CIP come about?
Loss of function in the gene SCN9A that encodes a particular voltage-activated Na+ channel (Nav1.7), highly expressed in nociceptive neurones
What are A(delta)-fibres ?
mechanical/thermal nociceptors that are thinly myelinated (conduction velocity of around 6-30ms-1 assoc. with nipping, stabbing etc
What are C-fibres?
Nociceptors that are unmyelinated (conduction velocity of 0.5-2.0ms-1)
assoc. with throbbing etc
What is TRP?
Transient receptor protein (responds to heat) particularly TRPV1
What do ASICs activate?
P2X and P2Y
What does bradykinin activate?
B2 receptors
What is ASICs activated by?
H+
What does ASIC stand for?
Acid Sensing Ion Channels
Give examples of anti-TNF drugs
Etanercept
Adulimumab
Certolizumab
Infliximab
What conditions are anti-TNF’s licensed for?
RA
psoriatic arhtritis
ankylosing spondylitis
What are side effects of anti-TNF’s?
Infection risk is increased
Cancer
Pulmoanry fibrosis
Heart failure
What does Rituximab do?
monoclonal antibody against B (CD20) lymphocytes
What does Tocilizumab do?
Inhibits IL-6
What does Abatacept do?
CTLA-4 Ig - blocks full activation of T lymphocytes
What does Ustekinumab do?
Inhibits IL-12 and IL-23`
What are the 2 components to treating gout?
Acute episode
Prophylaxis
How is the anti-TNF treatment decided?
DAWN questions
What prophylaxis drugs would be used?
Allopurinol
Febuxostat
Uricosurics
What is allopurinol?
A Xanthine oxidase inhibitor
What are side effects of allopurinol?
Rash (vasculitis)
marrow aplasia
Azothioprine interaction
What is Febuxostat?
Xanthine oxidase inhibitor
What are side effects of febuxostat?
Renal impairment
Caution with ischaemic heart disease
