Week 4 - pain control part 1

Question 1

categories of pain

Answer 1

nociceptive - localize - stabbing, aching
neuropathic - nerve involvement - burning, tingling
psychogenic - related to psyc

Question 2

substantia gelatinosa

Answer 2

dorsal horn of spinal cord

gate keeper to regulat nociceptive fibers

Question 3

NSAID

Answer 3

cox 1 and cox 2
reduce inflammation, fever and pain
reduce prostaglandins

Question 4

corticosteroids

Answer 4

reduce inflammation

Question 5

DMARD

Answer 5

work on inflammatory response

Question 6

opioids

Answer 6

binds to opioids receptors

Question 7

cannabinoids

Answer 7

mediate receptors in brain

modulate both ascending and descending pathway

Question 8

anaesthesia

Answer 8

alter nociceptive input

Question 9

gabapentinoids, SNRI, Trycyclic, antidepressant

Answer 9

alter NT level to modify nociception and pain perception

Question 10

NSAID

Answer 10

aspirin, ibuprofen, naproxen, indomethacin, diclofenac, celecoxib, meloxicam

Question 11

NSAID MOA

Answer 11

inhibits cox 1 and cox 2 enzyme - stop prostaglandins - decrease inflammation (anti-inflammatory) , pain (analgesic), fever (antipyretic)

may inhibit muscle fiber repair
most reversibly inhibit cox 1 and 2

Question 12

aspirin

Answer 12

NSAID - irreversibly inhibit cox 1 and 2
analgesia, antipyretic, anti inflammatory, antithrombotic
avoid if GI bleeding
avoid infant, teens

Question 13

Celecoxib

Answer 13

NSAID -
only cox 2 selective
do not use if CV issues

Question 14

NSAIDS risk

Answer 14

GI (COX 1)

kidney, CV (COX 2)

Question 15

Naproxen

Answer 15

NSAID - usually the safest

Question 16

best NSAID for GI issues

Answer 16

celecoxib or ibuprofen

Question 17

best NSAID if CV issues

Answer 17

naproxen

Question 18

avoid this NSAID if CV issues

Answer 18

celecoxib

Question 19

Acetaminophen (Telenol)

Answer 19

NOT NSAID
decrease pain, fever
AE = hepatotoxicity –> avoid if liver issues
good for elder

Question 20

OA : osteoarthritis

Answer 20

most common joint disease

Question 21

OA tx

Answer 21

acetaminophen (watch for unintentional overdose)

topical NSAID (voltaren)

intraarticular hyaluronate (for knee or hip)

intraarticular steroids

Question 22

over the counter tx for OA

Answer 22

glucosamine-chondroitin

Question 23

gold standard for RA tx

Answer 23

MTX

Question 24

RA tx

Answer 24

non biological DMARD
biological DMARD
corticosteroids

Question 25

Non biological DMARD

Answer 25

MTX, hydoxychloroquine

Question 26

biological DMARD

Answer 26

TNF inhibitor - humira, enbrel non TNF inhibitor - rituxan janus kinase inhibitor boxed warning

Question 27

TNF inhibitor

Answer 27

humira, enbrel

Question 28

non TNF inhibitor

Answer 28

rituxan

Question 29

Prednisone

Answer 29

corticosteroid tx for RA decrease inflammation, suppress immune system short term AE: increase blood glucose long term AE: osteoporosis, fracture risk, muscle waisting should take calcium and vitamin D

Question 30

Methotrexate (MTX)

Answer 30

``` gold standard non biological DMARD AE: liver kidney damage delay progression boxed warning ```

Question 31

Hydrocychloroquine

Answer 31

non biological DMARD only address symptoms not progression AE: GI, skin rxn

Question 32

biological DMARD

Answer 32

fight inflammation | AE: infusion rxn, infection

Question 33

rehab concern with DMARD

Answer 33

liver function + infection

Question 34

cannabinoids

Answer 34

endogenous exogenous CB1 receptors

Question 35

THC

Answer 35

primary psychoactive compound in marijuana

Question 36

CBD (cannabidiol)

Answer 36

non psychoactive compound of marijuana

Question 37

marijuana

Answer 37

schedule 1

Question 38

types of anesthesia

Answer 38

General Regional Local

Question 39

Phases of anesthesia

Answer 39

Analgesia / induction Delirium / disinhibition Surgical anesthesia Medullary paralysis

Question 40

What type of anesthesia result in hangover effect and why?

Answer 40

General (inhaled) | stored in adipose tissue

Question 41

Lidocaine

Answer 41

regional and local anesthesia

Question 42

Proposal

Answer 42

General anesthesia

Question 43

what do we need to look out for anesthesia?

Answer 43

respiratory depression