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Brain and behaviour 2 > Pharmacology of Pain > Flashcards

Pharmacology of Pain Flashcards

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The Brain flashcards
1
Q

Which is the fastest type of pain?

A

Seconds to minutes

Nociceptive

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2
Q

Which is the longest type of pain?

A

Days to months

Change in trophic factors

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3
Q

What type of pain takes minutes to days?

A

Sensitisation of terminals at the injury site + delayed central sensitisation

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4
Q

What are the three types of pain?

A

Nociceptive
Inflammatory
Neuropathic

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5
Q

What are targets for treatment in the dorsal horn?

A

COX-2
Nitric oxide synthase (NOS)
Glutamate receptors (NMDA)
Opioid receptors

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6
Q

Name structures activated by nociceptive stimuli?

A 
Spinal Cord
Thalamus
Somatosensory Cortec
Anterior cingulate cortec
Insula
Amygdala
Prefrontal cortex
Hippocampus
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7
Q

What factors influence pain perception?

A 
Cognition
Mood
Context
Genetics
Chemical + Structural
Injury
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8
Q

How do opioids work?

A

Act on opioid receptor to produce morphine-like effects

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9
Q

Name two opioid peptides

A

enkephalin + dynoprhins

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10
Q

What are peptides targets for?

A

peptidases

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11
Q

Give three opioid receptors

A

Mu
Delta
Kappa

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12
Q

What do Mu, Delta and Kappa opioid receptors have in common?

A

all GPCRs involved in GABA-ergic neurotransmission

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13
Q

What are examples of of opioids?

A

Codeine
Methadone
Morphine
Tramadol

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14
Q

How does morphine work?

A

Activates K+ conductance + decreases Ca2+ conductance

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15
Q

What is the overall effect of morphine?

A

Decreases excitability + release of NTs

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16
Q

What receptors does morphine activate?

A

Mu

17
Q

What are effects of opioids?

A 
Analgesia
Respiratory depression
Lethargy
Euphoria
Hypotension
Delayed gastric emptying
18
Q

What order is the analgesic ladder?

A
  1. Non-opioids (aspirin + paracetamol)
  2. Mild opioids (Codeine)
  3. Strong opioids (morphine)
19
Q

Give 4 examples of non-opioids

A

paracetamol
NSAIDS
Anticonvulsants
Antidepressants

20
Q

What is the mechanism of paracetamol?

A

Reduces active oxidised form of COX-2

21
Q

How does aspirin function?

A

COX 1 + COX 2 inhibitors

22
Q

How does ibuprofen (and diclofenac work)

A

COX 1 + COX 2 inhibitors + other functions

23
Q

What does Rofecoxib work?

A

Selective COX-2 inhibitor

24
Q

What indications are there for NSAIDs?

A

Arthritis
Gout
Muscle spasms

25
Q

What side effects of NSAIDs?

A

Nausea

GI Bleeding

26
Q

Give 3 examples of anticonvulsants

A

Carbamazepine
Pregabalin
Sodium valproate

27
Q

Give an example of antidepressant

A

Amitriptyline

28
Q

Give examples of local anaesthetic drugs

A

End in -CAINE
Prilocaine
Lignocaine
Bupivacaine

29
Q

How do local anaesthetics work?

A

Block Na+ channels

30
Q

What does blocking Na+ channels in local anaesthetic do?

A

Prevents transmission of nerve impulses without causing unconsciousness

31
Q

What are side effects of local anaesthetics?

A

Hypotension
Respiratory depression (hypoventilation)
Bradycardia

32
Q

How do general anaesthetics do?

A

Inhibit excitory receptor or activate inhibitory receptor

33
Q

How do general anaesthetic drugs end?

A

End in -ANE or -flurance

34
Q

What is trigeminal neuralgia?

A

Most common facial pain syndrome

35
Q

How is trigeminal neuralgia characterised?

A

Sudden, paroxysmal attacks of pain, sharp and stabbing

36
Q

Which side does trigeminal neuralgia affect and how long does it last?

A

Usually unilateral

Few seconds or minutes

37
Q

Cause of trigeminal neuralgia?

A

Compression of CN V root fibres by the anterior or posterior inferior cerebellar artery

38
Q

What treatment for trigeminal neuralgia?

A

Carbamazepine
Baclofen
Phenyltoin
Valproate

Brain and behaviour 2 (27 decks)

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