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BB2 > Pharmacology Of Pain > Flashcards

Pharmacology Of Pain Flashcards

1
Q

Types of pain

A

Nociceptive
Acute
Chronic
Neuropathic

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2
Q

Neuropathic pain

A

Chronic maladaptive pain after traumatic brain injury or spinal cord injury

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3
Q

How long does chronic pain last

A

12wk+

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4
Q

Which type of pain generally responds to analgesics and which doesn’t

A

Nociceptive responds
Neuropathic doesn’t

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5
Q

Targets for pain medications

A

COX2
NOS
NMDA and nonNMDA glutamate receptors
NK1 receptors
Opioid receptors

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6
Q

Factors influencing pain perception

A

Cognition - attention, distraction, control
Mood
Context - expectations, beliefs, placebo
Genetics
Chemical and structural - nerve dysfunction
Injury - sensitisation

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7
Q

Opioid peptides involved in nociception

A

Leu enkephalin
Met enkephalin
Dynorphin A
Nociceptin

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8
Q

What type of peptide is substance P

A

Tachykinin

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9
Q

3 families of opioid receptors

A

Mu - μ1 μ2 μ3
Delta - δ1 δ2
Kappa k1 k2 k3

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10
Q

Effects of opioids

A

Analgesia
Pupillary constriction
Sedation
Euphoria
Dysphoria
Respiratory depression
Reduced GI motility
Dependence
Drowsiness/legarthy
Nausea+vomiting
Hypotension
Itching

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11
Q

Why do opioid agonists have a broad spectrum of effects

A

Widespread distribution of opioid receptors

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12
Q

Mechanism of morphine

A

Activate potassium conductance and decrease calcium conductance causing decreased excitability and NT release

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13
Q

Opioid drugs

A

Codeine
Fentanyl
Hydrocodone
Hydromorphone
Levorphanol
Methadone
Oxycodone
Oxymorphone
Propoxyphene
Tramadol

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14
Q

What drug is used to reverse opioid overdose

A

Naloxone

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15
Q

Naloxone

A

Opiate antagonist used to reverse overdose

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16
Q

Why should opiates not be underdosed

A

Risk of tolerance developing

17
Q

3 steps of the analgesic ladder

A

1 Non opioids + adjuvants
2 moderate efficacy opioids + non opioids + adjuvants
3 high efficacy opioids + non opioids - adjuvants

18
Q

Non opioid painkillers

A

Paracetamol - analgesic antipyretic
Aspirin - analgesic antipyretic anti inflammatory
Ibuprofen, diclofenac, ketoprofen - analgesic, anti inflammatory
Selective COX2 inhibitors
Anticonvulsants - neuropathic pain, trigeminal neuralgia
Tricyclic antidepressants - neuropathic pain, cancer pain
SSRI
TRPV1 receptor ligands
NMDA glutamate receptor agonists
GABA receptor agonists
Local anaesthesia

19
Q

Which drugs acts on COX 1 and 2

A

Paracetamol
Aspirin
Ibuprofen
Diclofenac
Ketoprofen
Selective COX 2 inhibitors

20
Q

Anticonvulsant drugs

A

Carbamazepine
Sodium valproate
Pregabalin

21
Q

What type of drug is Amitryptyline

A

Tricyclic antidepressant

22
Q

What channel do carbamazepine and sodium valproate act on

A

Sodium

23
Q

What channel does pregabalin act on

A

Calcium - alpha2delta subunit

24
Q

Tricyclic antidepressants mechanism

A

Inhibit amine reuptake
Block sodium and calcium channels

25
Q

What type of drug is capsaicin

A

TRPV1 receptor ligand

26
Q

What type of drugs are ketamine and dextromethorphan

A

NMDA glutamate receptor agonist

27
Q

What type of drug is baclophen

A

GABA receptor agonist

28
Q

1st line drugs for neuropathic pain

A

SSRI
Tricyclic antidepressants
Anticonvulsants

29
Q

Local anaesthetic drugs

A

Lignocaine
Bupivacaine
Prilocaine

30
Q

Local anaesthetic mechanism

A

Block sodium channels

31
Q

Effects of anaesthetic system toxicity

A

Hypotension
Respiratory depression
Bradycardia

32
Q

General anaesthetic mechanism

A

Activate inhibitory receptors or inhibit excitatory receptors

33
Q

Do general anaesthetics act as analgesics

A

No, except ketamine

34
Q

What type of drugs are halothane enflurane isoflurane and nitrous oxide

A

Inhalation all general anaesthetics

35
Q

What type of drugs are propofol thiopental etomidate ketamine and midazolam

A

IV General anaesthetics

36
Q

Trigeminal neuralgia

A

Sudden paroxysmal attacks of electric shock like/sharp/stabbing pain to the face lasting a few seconds to a few minutes

37
Q

Trigeminal neuralgia main cause

A

Compression distortion or stretching of Trigeminal nerve by a branch of AICA or PICA

38
Q

Trigeminal neuralgia treatment

A

Carbamazepine, baclofen, phenytoin, sodium valproate, clonazepam

39
Q

Benzodiazepine mechanism

A

Active GABAa receptors

BB2 (26 decks)

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