Test 3: 38 pain 2

Question 1

opioids will cause — of the 2nd order neuron and — of the 1st order neuron

Answer 1

hyperpolarization (↑ K conductance)

inhibit NT (inhibit Ca channels)

Question 2

— are effeective at modulating pain but do not prevent the generation of noxious stimuli

Answer 2

opioids

Question 3

3 sites of action for opioids

Answer 3

peripherally, spinally, supraspinally

Question 4

opioids act on what in the pain pathway

Answer 4

transduction, modulation and perception

DOES NOT work on translation

Question 5

tramadol is what kind of med and causes what

Answer 5

full opioid agonist (M1)

also inhibits reuptake of serotonin and norepinephrine

Question 6

mechanism of NSAIDS

Answer 6

• Inhibit COX production of proinflammatory molecules from arachidonic acid pathway
• Prevents the generation of noxious stimuli
• Effective when inflammation is a major component of pain

Question 7

side effects of NSAIDS

Answer 7

Cox 2 selective – less side effects

• GI side effects – vomiting, diarrhea, ulceration
• Increase bleeding during surgery
• Renal injury
• Idiosyncratic hepatic necrosis reported in dogs

Question 8

Grapiprant (Galliprant) – blocks specifically — receptor

Answer 8

EP4 prostaglandin

OA treatment for dogs

Question 9

which part of pain pathway does NSAID work

Answer 9

transduction
modulation

Question 10

how does local anesthetics work

Answer 10

completely block the transmission of pain

• Reversible neuronal conduction blockade by Na+ channels
• reduces MAC
• May have anti-inflammatory effects by inhibiting proinflammatory mediator release and altering proinflammatory mediator activity
• Reduce free radical formation

Question 11

local anesthetics work on what parts of the pain pathway

Answer 11

transduction, transmission, modulation

Question 12

⍺2 agonist work in the

Answer 12

CNS (pain relief)

also CV, respiratory, endocrine, GI and urogenital

Question 13

⍺2 agonists work on what part of the pain pathway

Answer 13

transmission, modulation and perception

xylazine- large animal
dexmedetmidine- small animal
Atipamezole (reversal)
supraspinal analgesia,
peripheral: vasocontraction, ↑BP, reflex ↓HR.
Central: ↓SYMP, ↓BP, ↓HT
can ↓CO by 50%!

Question 14

what is a NMDA antagonist med

Answer 14

ketamine at low dose

Question 15

how do NMDA antagonist work

Answer 15

NMDA receptors are activated to process pain, can ↑ 2nd messangers → central sensitization

ketamine at low dose will block NMDA receptor, good for acute, chronic, neuropathic, cancer and burn pain

more effective for somatic than visceral pain

prevents wind-up/hyperalgesia if preemptive used

Question 16

NMDA antagonists work on what parts of the pain pathway

Answer 16

modulation- dorsal horn of spinal cord

might work supraspinally in the limbic and thalamocortical systems

Question 17

oral NMDA antagonist

Answer 17

Amantadine

Question 18

how do sedatives effect pain

Answer 18

not analgesic

but reduce anxiety and stress

Phenothiazines: acepromazine
benzodiazepines: diazepam, midazolam

Question 19

corticosteroid side effects

Answer 19

Polyuria/polydipsia, GI ulceration, iatrogenic Cushing’s disease

Question 20

corticosteroids work on pain by

Answer 20

Anti-inflammatory drugs
Peripherally inhibit inflammatory cascade

Question 21

how does gabapentin and pregabalin work

Answer 21

do not act on GABA receptors

• Spinal and supraspinal action
• Inhibition of sensory afferent neurons in peripheral nervous system
• Ca++ channel blockade

used as stress reducer in cats

Question 22

neurokinin (NK)-1 receptor antagonists

Answer 22

• NK-1 receptors are diffusely distributed around body and activated by substance P
• Role in nociception is still unclear
• Role in wind-up and hyperalgesia?
• Excellent antiemetics (maropitant/cernia)

Question 23

what are some antiNGF mAB meds

Answer 23

Anti- nerve grow factor monoclonal antibody

• cats – frunevetmab (Solensia)
• Future: Dogs – bedinvetmab (Librela®)

Question 24

nutraceuticlas

Answer 24

omega 3 fatty acids

help ↓ OA and degenerative joint disease pain

Question 25

how does cold therapy work on pain

Answer 25

• Decrease activation of tissue nociceptors and slow conduction velocity
• Vasoconstriction – reduce edema formation, deliver inflammatory mediators
• Decrease neuronal activity – reduce neurogenic inflammation