Pharmacology of Pain Flashcards
Which structures may be targeted to alleviate nociceptive pain?
COX-2, NOS, NMDA, NK1 and opioid receptors
What endogenous system promotes nociception?
Cholecystokinin (CCK)
Explain the mechanism of action of morphine
Activates potassium conductance and reduces calcium conductance to reduce excitability and decrease neurotransmitter release
How does paracetamol work?
Reduces COX-2 and acts as an anti-pyretic and analgesic
Name four examples of NSAIDs
Aspirin, ibuprofen, diclofenac and rofecoxib
How does aspirin work?
Inhibits COX-1 and COX-2 and is an anti-pyretic and analgesic
How do ibuprofen and diclofenac work?
COX-2 inhibitors
How does rofecoxib work?
Selective COX-2 inhibitor
What are the side-effects of NSAID use?
Nausea and GI bleeding
Aside from epilepsy, how may anticonvulsants, such as carbamazepine, pregabalin and sodium valproate, be used?
To treat neuropathic pain and trigeminal neuralgia
How do carbamazepine and sodium valproate work?
Act on sodium channels to cause opening to hyper polarise the cell to prevent firing
How does pregabalin work?
It acts on the a2-delta subunit of calcium channels to prevent neurotransmitter release
How does local anaesthetic work?
Blocks sodium channels to prevent action potentials from being generated so pain cannot be signalled to the brain
Name three examples of local anaesthetic
Lignocaine, bupivacaine and prilocaine
What is trigeminal neuralgia?
Sudden attack of electric-shock pain and stabbing due to compression or stretching of the trigeminal (CN V) nerve root by a branch of the anterior or posterior inferior cerebellar artery
