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2.1 T1: Fundamental Neuroscience and the Brain > T1 L22: Analgesia, Sedation, and local anaesthetic > Flashcards

T1 L22: Analgesia, Sedation, and local anaesthetic Flashcards

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1
Q

What is analgesia?

A

Medication that relieves pain

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2
Q

What is the gate theory of pain?

A

It suggests that the spinal cord contains a neurological “gate” that either blocks pain signals or allows them to continue on to the brain

Physiology: C fibres let pain through but Ab fibres stimulate inhibitory neurones. the descending pathways prevent central passage

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3
Q

What are some methods of scoring pain?

A

Linear (1-10)
Smiley/sad faces
Mild, moderate, severe, or excruciating

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4
Q

What is the WHO analgesic ladder?

A

It starts with aspirin and NSAIDS if pain unrelieved. Then you can add some local anaesthetic and weak opioids and the final step is strong opioids

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5
Q

What is the WFSA analgesic ladder?

A

The World Federation of Societies of Anaesthesiologists (WFSA) Analgesic Ladder has been developed to treat acute pain

First you would give strong opioids by injection or some local anaesthetic and then you would move downwards into opioids by mouth as pain decreases and finally onto aspirin and NSAID’s

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6
Q

What is the drug Naloxone used for?

A

Causes acute drug withdrawal. It acts on opioid receptors and antagonises them

It’s an opioid

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7
Q

Why does Naloxone often need to be re-administered?

A

Because it has a really short half-life

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8
Q

What are some methods of administration of analgesic agents?

A 
Intravenous patient control analgesia
Infusion
Intramuscular
Oral
Intra nasal/aerosol
Epidural/spinal
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9
Q

Where are opioid receptors found in the body?

A 
Pons and mid brain
Periaqueductal grey matter
Nucleus raphe magnus
Spinal cord posterior horn 1 and 2
Peripheral tissue 
GI tract
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10
Q

Why are there so many opioid receptors around the body?

A

Because the body produced its own endorphins

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11
Q

Which opioid subtypes cause nausea?

A

Kappa OP2

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12
Q

Which opioid subtype causes respiratory depression?

A

Delta OP1

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13
Q

What are some side effects of using morphine?

A

Respiratory depression
Nausea and vomiting
Constipation
Miosis (shrinking of pupils)

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14
Q

Which receptors does Ketamine act on?

A

NMDA
Kappa and delta
Not GABBA

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15
Q

What is the triad of ketamine action?

A

Local/general analgesic
Anaesthesia
Sedative

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16
Q

Which analgesic drug can be used for its antisuicidal effects with depression?

A

Ketamine

17
Q

What is the physiology behind the action of NSAID’s?

A

Inhibit COX 1 and 2

18
Q

What is the triad of NSAID action?

A

Analgesic, Antipyretic, inti inflammatory

19
Q

What does antipyretic mean?

A

Reduces fever

20
Q

What are some side effects of NSAID’s?

A

Gastric irritation
Bronchospasm
Renal impairment
Platelet function (aspirin)

21
Q

Why is aspirin not used for children?

A

Because of Reyes syndrome

  • A rare but serious condition that causes swelling in the liver and brain. It mostly affects children and teenagers recovering from a viral infection, most commonly the flu or chickenpox
22
Q

What happens during a paracetamol overdose?

A

Hepatotoxicity and Glutathione depletion

23
Q

Give examples of some antiemetic drugs

A 
Hyocine
Metaclopromide
Steroids
Prochlorperazine
Cannabinoids
Propofol
24
Q

Describe the Ramsay Sedation scale

A 
Patient anxious
cooperative
responds only to commands
Brisk response to Glabellar tap/shout
Sluggish response
No response
25
Q

What is a Glabellar tap?

A

A tap on the head between the eyes to see if the person blinks

26
Q

What is the main drug used for sedation?

A

Benzodiazepines

27
Q

How do Benzodiazepines work?

A

They work on GABBA A and B (inhibitory neurotransmitter)

28
Q

What are some side effects of benzodiazepines?

A

Over sedation
Loss of airways
Respiratory depression
ABC

29
Q

What happens in the body during a local anaesthetic overdose?

A

Vasoconstriction

Ventricular fibrillation

30
Q

How is an overdose of local anaesthetic treated?

A

ABC
Oxygen
Lipid 20% (lipid rescue)

31
Q

How can local anaesthetics be given?

A

Spinal epidural caudal
Skin
Aerosol/ Nebulised

2.1 T1: Fundamental Neuroscience and the Brain (24 decks)

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