Analgesia And Pain Management Flashcards

1
Q

Pain types

A

Nociceptive
Inflammatory
Neuropathic
Nociplastic

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2
Q

Inflammatory mediators released when tissue is damaged

A

K+
H+
Bradykinin
Histamine
5HT
NO

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3
Q

Which pathway produces leukotrienes and prostanoids

A

Arachidonic pathway

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4
Q

Neuropathic pain mechanisms

A

Altered ion channel expression
Ectopic and spontaneous discharge
Emphatic conduction
Collateral sprouting at Pri afferents
Sprouting of sympathetic neurones at DRG

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5
Q

Nociplastic pain mechanisms

A

Central pain sensitisation
Dysfunctional inhibitory pathways

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6
Q

Pain inhibitory pathways

A

GABA
Opioid
Mono aminergic
Cannabinoid

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7
Q

Nociceptive pain

A

Appropriate physiological detection of painful stimulus

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8
Q

Inflammatory pain

A

Enhanced nociception in the presence of inflammation

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9
Q

Neuropathic pain

A

Pain initiated or caused by a primary lesion/dysfunction in the nervous system

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10
Q

Nociplastic pain

A

Pain arising from altered nociception despite no clear evidence of actual or threatened tissue damage

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11
Q

How long does acute pain last

A

<12 wks

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12
Q

How long does chronic pain last >12wks

A
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13
Q

Pain measurement tools

A

VAS Visual analogue score
VRS verbal rating score
Observer scoring
BPI
Magill pain questionaire
SF36
EQ5D

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14
Q

3 steps in pain relief ladder

A

Non opioid
Weak opioid
Strong opioid

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15
Q

Non opioid painkillers

A

Aspirin
Paracetamol
Ibuprofen
Diclofenac
COX2 inhibitors

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16
Q

Weak opioid painkillers

A

Codeine
Dihydrocodeine
Tramadol

17
Q

Strong opioid painkillers

A

Morphine
Hydromorphone
Oxycodone
Buprenorphine
Fentanyl
Methadone

18
Q

What symptoms does paracetamol improve

A

Moderate pain
Pyrexia

19
Q

Main effect of paracetamol overdose

A

Liver damage

20
Q

Paracetamol administration

A

Oral
IV
PR

21
Q

What drug class is naproxen

A

NSAID

22
Q

How does naproxen inhibit prostaglandin

A

COX1 and 2 inhibition

23
Q

Naproxen adverse effects

A

GI bleeding
GI ulcers
Renal effects
CVS effect

24
Q

Tramadol and tapentadol administration

A

Oral
IV
IM

25
Q

Which pathway does Tramadol target

A

Monoaminergic pathway

26
Q

Tramadol and tapentadol side effects

A

Nausea
Vomiting
Dizziness
Sweating

27
Q

Opioid MOA

A

Mimic endogenous analgesic peptides and act on opioid recpetors

28
Q

Endogenous analgesic peptides

A

Endorphins
Dynorphins
Enkephalins

29
Q

3 main opioid receptor types

A

Mu
Kappa
Delta

30
Q

Which opioid receptor does morphine act on

A

Mu

31
Q

Morphine administration

A

IV
IM
SC
oral
Epidural
Intrathecal
IA

32
Q

Morphine side effects

A

Constipation
Nausea
Pruritis
Drowsiness

33
Q

Medications for neuropathic pain

A

Anti neuropathic agents
Anticonvulsants
Antidepressants
Topical creams

34
Q

Antineuropathic agents

A

Pregabalin
Gabapentin
Carbamazepine
Sodium valproate
Phenytoin

35
Q

Is THC Or CBD psychoactive

A

THC

36
Q

What type of molecule are endocannabinoids

A

Lipids

37
Q

Anaesthetic techniques

A

Topical application
Local infiltration
Simple nerve block
Plexus block
Epidural infusion