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Module 202 Neuroscience & behaviour > T1 L24 Analgesics, anaesthetic & sedation drugs > Flashcards

T1 L24 Analgesics, anaesthetic & sedation drugs Flashcards

1
Q

What is pain?

A

Unpleasant sensory & emotional experience associated with actual or potential tissue damage

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2
Q

Describe gate theory

A

C fibres let pain through
AB fibres stimulate inhibitory neurons
Descending pathways prevent central passage

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3
Q

Describe pain modification

A

Nociceptor C
A delta fibes
Central interpretation
Not just drugs

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4
Q

How can pain be scored?

A

Linear
Smiley / sad faces
Mild, moderate, severe, excruciating

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5
Q

Describe the WHO analgesic ladder

A

Aspirin & NSAIDs
Add local anaesthetic & weak opioids
Add strong opioids

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6
Q

Describe the WFSA analgesic ladder

A

Aspirin & NSAIDs
Opioids by mouth
Strong opioids by injection, local anaesthesia

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7
Q

Where do opioids act?

A

On opioid receptor

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8
Q

What antagonises opioids?

A

Naloxone

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9
Q

What are examples of naturally occurring opioids?

A

Morphine

Codeine (weaker)

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10
Q

Give example of a semi-synthetic opioid

A

Diamorphine

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11
Q

Give an example of a synthetic opioid

A

Fentanyl

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12
Q

How can opioids be administered?

A 
Intravenous / infusion
Intramuscular
Oral
Intranasal / aerosol
Epidural / spinal
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13
Q

Where are opioid receptors located?

A 
Pons & midbrain
Periaqueductal grey matter
Nucleus raphe Magnus 
Spinal cord posterior horn 1 & 2
GI tract
Peripheral tissues
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14
Q

What are the subtypes of opioid receptors?

A

MU 1 & 2
OP3
Delta - OP1
Kappa - OP2

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15
Q

What are the side effects of morphine?

A

Respiratory depression / airway loss
Nausea / vomiting
Constipation / pruritus
Miosis

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16
Q

Describe ketamine

A 
NMDA antagonist
Kappa & delta receptors
Analgesic local / general
Anaesthetic
Sedative
Side effects: emergence phenomena
17
Q

Describe NSAIDs

A

Inhibit cyclooxyrgenase 1 & 2
Analgesic
Antipyretic
Anti-inflammatory

18
Q

What are the side effects of NSAIDs?

A

Gastric irritation
Bronchospasm
Renal impairment
Platelet function - aspirin

19
Q

Describe aspirin

A

Acetylsalicylic acid
Oxidative phosphorylation
Air hunger
Reyes syndrome

20
Q

Describe paracetamol

A

Mechanism is unknown

Central prostaglandin effect

21
Q

What are the effects of an overdose of paracetamol?

A

Hepatotoxicity

Glutathione depletion

22
Q

What are some other methods of analgesia?

A 
Anxiolysis
Local anaesthetics
Antidepressants, anti epileptics, tramadol
Guanethadine, ketamine, clonidine
Acupuncture
Inhalation nitrous oxide
Penthrox
Magnesium
23
Q

What is used as an anti-emetic?

A 
Propofol
Cyclizine
Ondansetron
Hyoscine
Metoclopramide
Steroids
Prochlorperazine
Cannabinoids
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

Give examples of some benzodiazepines

A

Midazolam
Diazepam
Lorazepam

26
Q

Describe the physiology of benzodiazepines

A

GABA
Inhibitory neurotransmitter
Receptors A & B

27
Q

Describe the side effects of benzodiazepines

A

Over-sedation
Loss of airway
Respiratory depression

28
Q

What can be given to reduce side effects of benzodiazepines?

A

Flumazenil

29
Q

Give examples of some other sedatives

A 
Low dose vapours
Ketamine
Hyoscine
Propofol at low dose
Major tranquilisers
Alpha 2 agonists
30
Q

What are the categories of other sedatives?

A

Amides

Esters

31
Q

Give an example of an amide sedative

A

Lignocaine
Prilocaine
Bupivacaine

32
Q

Give an example of an ester sedative

A

Cocaine

Amethocaine

33
Q

Give examples of the mechanisms of other sedatives

A

Na channel blockade
Un-ionised drug through membrane into axoplasm
Protonated
Blocks channel –> blocks action potential

34
Q

Methods of administering sedatives

A 
Anatomy local blocks / ultrasound
Spinal epidural caudal
skin
Aerosol / nebulised
Combination with GA
35
Q

What are some cardiovascular symptoms of toxicity?

A

Dysrhythmias

Cardiac depression

36
Q

What are some central nervous system symptoms of toxicity?

A

Fitting
Anxiety
Loss of consciousness
Circumoral numbness

37
Q

What is the treatment for toxicity?

A

ABC
Oxygen
Lipid - 20%
Dysrhythmias / fitting

Module 202 Neuroscience & behaviour (39 decks)

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