Pain and analgesia Flashcards

1
Q

Pain?

A

“An unpleasant sensory and emotional experience, associated with actual tissue damage or described in terms of such damage”

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2
Q

What are the 3 classified pain? with example of fire alarm

A

(i) Nociceptive (acute/sharp) pain (e.g. pin prick, visceral distension)
(ii) Inflammatory (prolonged) pain (e.g. sunburn, inflamed wound)
(iii) Pathological pain

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3
Q

Nociceptive pain begins with the activation of —–

A

nociceptors

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4
Q

about nociceptors?

A
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5
Q

Nociceptive pain is —- ; serves as an early warning system to detect and minimise contact with damaging stimuli (noxious events)

Nociceptive pain is —- threshold – provoked only by intense stimuli that activate nociceptors

A

adaptive
high

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6
Q

Nociceptors are —– order neurons that relay information to second order neurons in the CNS by chemical synaptic transmission.

A

first

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7
Q

what is the benefit of nociceptive pain?

A
  • initiates a withdrawal reflex
  • is extremely unpleasant
  • engages adverse emotional components
  • serves to inscribe memories that allow avoidance of harm in the future
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8
Q

Inflammatory pain?

A
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9
Q

Pathological pain?

A
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10
Q

what mutation causes the absence of pain?

A

in the gene SCN9A that encodes a particular voltage-activated Na+ channel (Nav1.7) that is highly expressed in nociceptive neurons

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11
Q

Nociceptors are —– —– neurons innervating peripheral tissues—activated only by mechanical, thermal, or chemical stimuli that are noxious. Comprise —– and —–fibres.

A

primary afferent
mechanical
thermal
chemical
noxious

C

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12
Q

Aδ?

A

fibres are mechanical/thermal nociceptors that are thinly myelinated (conduction velocity of 6-30 ms-1 ) & respond to noxious mechanical and thermal stimuli. Mediate ‘first’, or fast, pain.

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13
Q

C-fibres?

A

C-fibres are nociceptors that are unmyelinated (conduction velocity of 0.5 – 2.0 ms-1) – collectively they respond to all noxious stimuli (i.e. they are polymodal). Mediate ‘second’, or slow, pain

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14
Q

Aδ vs C fibre?

A
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15
Q

examples of stimuli that activate the peripheral terminals of polymodal nociceptors

A
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16
Q

Primary afferent axons terminate centrally in the —- horn of the spinal cord in —- to —- laminae of Rexed

A

dorsal
I to V

17
Q

Nociceptive C- and Aδ-fibres mostly terminate superficially in laminae—– and —– (and also V for — -fibres)

A

I and II

18
Q

Strategies in the pharmacological management of pain?

A
19
Q

—— – substances extracted from opium, or of similar structure to those in opium
—— – any agent (including endogenous peptides, known collectively as endorphins/enkephalins) that act upon opioid receptors

A

Opiates
Opioids

20
Q

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce ——
Non-selective NSAIDs have analgesic, antipyretic and anti-inflammatory actions, largely by inhibiting the synthesis and accumulation of prostaglandins by enzymes; —— and ——-
Examples of NSAIDs?

A

nociceptor sensitization
COX 1 and COX 2
Non-selective NSAIDs

aspirin
ibuprofen
naproxen
diclofenac
indometacin

21
Q

Cellular action of opioids and analgesia

A