Week 230 - Pain Flashcards
Week 230
Ibuprofen, paracetemol and naproxen are all _____ analgesics.
Non-opioid
Week 230
Codeine, dihydrocodeine, fentanyl, morphine, oxycodone, tramadol are all ____ analgesics
Opiod
Week 230
What is nociceptive pain?
Pain caused by stimulation of nociceptive
receptors and transmitted over intact neural pathways
AKA
Nociceptive pain is caused by damage to body tissue and usually described as a sharp, aching, or throbbing pain. This kind of pain can be due to benign pathology; or by tumors or cancer cells that are growing larger and crowding other body parts near the cancer site. Nociceptive pain may also be caused by cancer spreading to the bones, muscles, or joints, or that causes the blockage of an organ or blood vessels.
Week 230
What is neuropathic pain?
Pain caused by damage to
neural structures
AKA
Neuropathic pain occurs when there is actual nerve damage. Nerves connect the spinal cord to the rest of the body and allow the brain to communicate with the skin, muscles and internal organs. Nutritional imbalance, alcoholism, toxins, infections or auto-immunity can all damage this pathway and cause pain. Neuropathic pain can also be caused by a cancer tumor pressing on a nerve or a group of nerves. People often describe this pain as a burning or heavy sensation, or numbness along the path of the affected nerve.
Week 230
What is step 1 on the WHO ladder of analgesia?
Non-Opioid +/- Adjuvants
Week 230
What is on the WHO level 2 ladder of analgesia?
Weak opioid
+ non-opioid
+/- adjuvants
Week 230
What is step 3 on the WHO ladder of analgesia?
Strong Opioid
+ Non-opioid
+/- adjuvants
Week 230
Name two weak opioid analgesic drugs
Codeine
Dihydrocodeine
week 230
Name 3 strong opioid analgesic drugs
Fentanyl
morphine
oxycodone
Week 230
What is the antidote for an opioid overdose?
Naloxone
Week 230
Increase breakthrough oromorph to 15%. He is already on Step 3. Paracetemol would not help. The other doses are too much of an increase - only increase by no more than 50% for each change.
Week 230
Tramadol stimulates the release of which neurotransmitter?
Serotonin
Week 230
N and V
Week 230
What is one of the key symptoms of morphine toxicity?
Hypotension
Week 230
How do Gabapentin and Carbamazepine act as analgesics?
These are anti-epileptic drugs. They work by reducing neuronal excitability.
Week 230
Congenital insensitivity to pain is usually as a result of a mutation of which transporter?
Na+
Week 230
Define: Dysasthesia
Abnormal, unpleasant experience, but not pain in itself.
Week 230
Define: Hyperalgesia
Increased pain response to noxious stimuli
Week 230
Define: Allodynia
Pain response to non-noxious stimuli
Week 230
Define: Paraesthesia
Pain response in the absence of any stimuli
Week 230
Define: Paroxysms
Spontaneous shooting pains
Week 230
DEfine: Hyperpathia
Increased pain threshold, but also an increased pai nresponse once the threshold has been reached.
Week 230
TRPV1 receptors detect what, and above which threshold?
Temperature. Depolarise above 43 degrees celsius.
Week 230
What do mechanical receptor detect?
Stretch
Week 230
What do chemical receptor detect?
Inflammation
Week 230
What are Aδ Fibres?
This is the rapid “fast” pain fibres. They are myelinated, with a large diameter Intended to send a sharp initial stimulus, but pain is not distiguishable.
Week 230
With regards to pain and nociception, what are C fibres?
These are the slow, unlyelinated pain fibres. They allow one to distinguish between different types of pain.
Week 230
Why does rubbing something that is hurt reduce the pain?
This is because of A Beta (Type 2) fibres, that transmit the sensation of proprioception, deep touch and pressure through the dorsal column - they inhibit pain signals sent through nociceptive pathways (these originate in the spinothalamic tracts but are inibited/dampened down as thy decussate into the dorsal root ganglion).
Week 230
What are enkephalins?
These are endogenous opioids
Week 230
What does substance p do?
This causes mast cell degranulaton - release of histamine - further inflammation!
Week 230
What is trigeminal neuralgia?
This is intesneive episodic pain, usually caused by compression of the trigeminal nerve. Treated with anticonvulsants.
