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Pharmacology Y2 > Pain > Flashcards

Pain Flashcards

1
Q

List 5 causes of pain

A

Inflammation
Neuropathy
Headache
Central pain (spinal cord injuries)
Cancer pain (tissue and nerve damage)

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2
Q

Which system of the brain attaches emotions to pain?

A

Limbic system

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3
Q

List 7 co-morbidities associated with pain

A

Difficulty sleeping
Lack of energy
Drowsiness
Difficulty concentrating
Anxiety
Poor appetite

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4
Q

Does the brain have pain sensors?

A

No, it is the only part of the body without pain sensors

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5
Q

What is nociceptive pain?

A

Pain from damaged non neural tissue, which activates nociceptors

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6
Q

Give an example of nociceptive pain

A

Lower back pain

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7
Q

What is neuropathic pain?

A

Pain caused by a lesion or disease of the somatosensory nervous system

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8
Q

Give 2 examples of neuropathic pain

A

Carpal tunnel syndrome
Trigeminal neuralgia

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9
Q

What is nociplastic pain?

A

Pain from nociceptors but no evidence of lesion of tissue damage

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10
Q

Give an example of nociplastic pain

A

Fibromyalgia

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11
Q

What are 6 factors that aid the transduction of pain from receptors?

A

5HT
Capsaicin
H+
Substance P
Prostaglandins
Na+ and Ca2+ channels

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11
Q

What are 6 factors that aid the transduction of pain from receptors?

A

5HT
Capsaicin
H+
Substance P
Prostaglandins
Na+ and Ca2+ channels

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12
Q

What receptors do Triptans target to block transduction of pain?

A

TRPV receptors that respond to heat - capsaicin

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13
Q

What receptors do CGRP antibodies target to block transduction of pain?

A

Substance P receptors that respond to mechanical stimulus

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14
Q

What receptors do NSAIDS target to block of pain?

A

Prostaglandin receptors that respond to cold stimulus

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15
Q

Why are NSAIDs always useful in treating pain?

A

NSAIDs reduce inflammation, and inflammation will always be a component of pain

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16
Q

What receptors does lidocaine target to block the transduction of pain?

A

Na+ and Ca2+ channels

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17
Q

Why is lidocaine not always useful?

A

It is non specific so may have other side effects as well as blocking pain

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18
Q

Give 2 examples of NSAIDs

A

Aspirin
Ibuprofen

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19
Q

Name the specific receptors that NSAIDs block

A

COX1
COX2
Cyclo-oxygenase

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20
Q

Why should patients be wary of stomach problems when taking ibuprofen?

A

Prostaglandins help production of stomach mucus, so blockage of this will make the stomach more susceptible to damage from stomach acid

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21
Q

Why does paracetamol function as an effective painkiller?

A

It targets receptors in the spinal cord and the brain

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22
Q

What is a negative factor of paracetamol?

A

It is metabolised quickly by the liver so has a narrow therapeutic window

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23
Q

Which pain blockers are effective for migraines?

A

Triptans
CGRP antibodies

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24
Q

Define hyperalgesia

A

More pain in response to a pain stimulus

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25
Q

Define allodynia

A

Over sensitivity of pain fibres resulting in pain from a non painful source

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26
Q

Name 2 calcium channel blockers that block the release of neurotransmitter

A

Gabapentin
Pregebalin

27
Q

Name a potassium channel opener that increases outward currents of K+

A

Opioids

28
Q

Name 2 sodium channel blockers that block the inward currents of Na+

A

Lidocaine
Carbamazepine

29
Q

What is the disadvantage of taking calcium channel blockers for pain relief in the long term?

A

Can cause low blood pressure, resulting in negative effects on the heart - not good for the long term

30
Q

Why is it advantageous to use NA+ blockers rather than Ca2+ blockers for pain?

A

There are many different specific Na+ channels, so easier to target specific channels for specific pain relief

31
Q

Which Na+ channels are specific to C fibres?

A

NaV. 1.7+1.8

32
Q

What happens to C fibres when they have repeated input?

A

It increases their sensitivity so they are hyper responsive to pain

33
Q

Why does repeated input increase C fibre sensitivity?

A

The Mg2+ ion that blocks NMDA receptors is removed

34
Q

What drug can be used to prevent increased C fibre sensitivity?

A

Ketamine

35
Q

How does Ketamine prevent increased C fibre sensitivity?

A

It blocks the NMDA channels

36
Q

What is brainstem analgesia?

A

When in a fight or flight response the PAG is activated so that pain is not detected at that time

37
Q

How can mood affect pain?

A

Depressed patients complain of pain, they are linked

38
Q

What is the mechanism of action of heroin?

A

It penetrates into the CNS and loses its acetyl groups, becoming morphine

39
Q

On which receptors does heroin act on?

A

G protein coupled receptors

40
Q

Where are the majority of receptors located which heroin acts on?

A

In the PAG
In the substantial gelatinosa

41
Q

Which channels are opened by morphine and heroin?

A

K+ channels

41
Q

Which channels are opened by morphine and heroin?

A

K+ channels

42
Q

Name the 4 opioid receptors

A

Mu
Kappa
Delta
ORL-1

43
Q

What is the natural neurotransmitter for Mu opioid receptors?

A

Endomorphins

44
Q

What is the natural neurotransmitter for Delta opioid receptors?

A

Enkephalins

45
Q

What is the natural neurotransmitter for Kappa opioid receptors?

A

Dynorphin

46
Q

What is the natural neurotransmitter for ORL-1 opioid receptors?

A

Nociceptin

47
Q

Name 2 drugs that act on Mu opioid receptors

A

Morphine
Pethidine

48
Q

Name a drug that acts on Delta opioid receptors

A

DPDPE

49
Q

Name a drug that acts on Kappa opioid receptors

A

U50488H

50
Q

Which 3 opioid receptors conduct the opening of K+ channels?

A

Mu
Delta
ORL-1

51
Q

Which opioid receptor conducts closure of Ca2+ channels?

A

Kappa

52
Q

Name 2 pro drugs fro morphine

A

Heroin
Codeine

53
Q

Which opioid is used for surgical procedures?

A

Fentanyl

54
Q

What is an antagonist for opioid receptors?

A

Naloxone

54
Q

What is an antagonist for opioid receptors?

A

Naloxone

55
Q

Which fibres are not affected by opioids?

A

Alpha beta fibres

56
Q

Can you still feel pain if alpha beta fibres are not inhibited?

A

No, you will be able to feel touch but not pain

57
Q

How do opioid affect pre synaptic receptors?

A

They inhibit release of glutamate and peptide neurotransmitters

57
Q

How do opioid affect pre synaptic receptors?

A

They inhibit release of glutamate and peptide neurotransmitters

58
Q

How do opioids affect post synaptic receptors?

A

They hyper polarise the output neurone

58
Q

How do opioids affect post synaptic receptors?

A

They hyper polarise the output neurone

59
Q

List 4 side effects fo opioids

A

Respiratory depression
Anti-tussive (blocks cough reflex)
Constipation
Nausea and vomiting

60
Q

What is the function of on cells in descending pathways?

A

They turn up the effect of pain

Pharmacology Y2 (9 decks)

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