Week 2 Acute Pain Pharma Flashcards
describe the mechanism of acute pain
you have an injury to the tissue, which causes inflammation and then a mediator response. This will stimulate the nociceptor, and will send a signal up the spinothalamic tract to the thalamus and then the somatosensory cortex.
what are the two most common substances in a chemically mediated response to pain
prostaglandins and substance P
is the described mechanism the reality of how we feel pain?
no, it is very complex, with various mechanisms
what is The WHO pain ladder
you try adjuvant and nonopioids at the first level. Then you move to opioids and more opioids
what is nocioceptive pain
noxious peripheral stills that affects the structure, like mechanical, chemical, heat and cold,
what is the difference between somatic and visceral nocioceptive pain
somatic is injury to the bone or skin
visceral comes from organs, compression or dissension. This can be things like pancreatitis and cancer pain
what is neuropathic pain
more in chronic, and damage to the PNS or CNS. things like burning types of pain
what are some ways we can assess intensity
word scales, VAS, Wong-Baker FACES pain scale
what are some descriptive terms for pain
throbbing, aching, cramping= nocioceptive
burning, tingling, stabbing, shocking = neuropathic.
when do you use acetaminophen
with mild or moderate pain, or for more moderate to severe pain if you mix it with an opioid
what is Percocet
oxycodone and acetaminophen
what is Vicodin
hydrocodone and acetaminophen
TF: acetaminophen is commonly used to reduce fever
true
acetaminophen has a mild adverse effect profile, but what is a big concern with taking high doses
liver damage/toxicity
TF: acetaminophen is preferred for things like OA when you have GI sensitivity
true
what are NSAIDS examples
non-steroidal anti-inflammatory drugs
- aspirin
- COX1 inhibitor
- COX 2 inhibitor
what do prostaglandins lead to
inflammation and pain when injury occurs,
what does cyclooxygenases do
converts arachidonic acid to prostaglandins, which is responsible for inflammation and pain when an injury occurs.
how do NSAIDS work
they block the COX enzymes, which converts the arachidonic acid to prostaglandins, which is then blocking pro-inflammatory things.
what are eicosinoids
local hormones like prostaglandins, thromboxanes and leukotrienes
what is the relationship between prostaglandins and the GI tract
prostaglandins are protective in the stomach and the GI tract, so taking these can cause stomach irritation
more COX2 selective means what for the GI tract
less stomach upset and bleeding
what does COX1 help to protect
the stomach lining because of prostaglandins
what is the relationship between COX 2 and cardiac risk
COX 2 selective drugs shift the balance of platelet activity to favor increased clotting by inhibiting prostacyclin (which promotes vasodilation and prevents platelet occlusion in the carotid arteries). but continues to allow thromboxane (which promotes platelet aggregation)
