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Neurology Week 5 2018/19 > 2: Pain management > Flashcards

Flashcards in 2: Pain management Deck (33)
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1

What is pain?

Unpleasant sensory or emotional experience

Associated with actual tissue damage OR described in terms of it

2

Different individuals have different ___ to pain.

sensitivities

3

What is the function of pain?

Protective

Stops you from exposing yourself to dangerous stimuli

4

When does acute pain resolve?

Once healing has occurred

5

Chronic pain is (adaptive / maladaptive).

maladaptive

i.e there's no point to it

6

How is pain measured?

Why is this problematic?

Scales / ratings

Pain is subjective, different people have different sensitivities

7

What are physiological responses to pain?

Hypertension

Tachycardia

8

___ and ___ are physiological responses to pain.

(brady/tachycardia, hypo/hypertension)

Tachycardia

Hypertension

9

Patients must be allowed to ___-___ the severity of their pain.

self-report

10

Which brain structures receive nociceptive signals?

Amygdala

Hypothalamus

Thalamus

11

Which brain structures are responsible for

a) attention

b) sensation

in response to nociceptive signals?

a) Amygdala and hypothalamus

b) Thalamus (spinothalamic tract, to post-central gyrus i.e sensory strip)

12

What is nociceptive pain?

Appropriate response to painful stimuli by an intact nervous system

13

What is neuropathic pain?

Inappropriate response to stimuli by a dysfunctional nervous system

14

What history should you take from anyone complaining of pain?

SOCRATES

15

Allodynia and hyperalgesia are types of neuropathic pain.

What do these words mean?

Allodynia - pain in response to non-painful stimuli e.g cotton wool

Hyperalgesia - exaggerated pain in response to a painful stimulus e.g pin prick

16

What is a chronic pain condition often seen after shingles?

Post-herpetic neuralgia

17

What is a chronic pain condition sometimes seen after back surgery?

Failed back syndrome

18

Which endocrine disease causes peripheral neuropathy, of which chronic pain can be a symptom?

Diabetes

19

What is phantom pain?

Chronic pain in amputees, felt where the limb should be

20

Which pathway should be used when managing pain conditions?

WHO pain ladder

21

What are some examples of non-opioid drugs used to manage low grade pain?

Aspirin, Ibuprofen, Naproxen, Diclofenac (i.e NSAIDs, which act on cycloxygenase 1, lots of side effects)

Paracetamol

22

Name three examples of NSAIDs.

Which enzyme do they inhibit?

Which inflammatory mediator does this action affect?

Aspirin, ibuprofen, diclofenac, naproxen, indomethacin

COX (cyclo-oxygenase 1 or 2, depends on the drug)

Prostaglandin (so NSAIDs dampen down inflammation)

23

What are some of the side-effects of NSAIDs?

Peptic ulceration

Renal toxicity

(COX-2 inhibitors, -coxibs, have cardiovascular side effects)

24

What is an important side effect of paracetamol?

Hepatotoxicity

ESPECIALLY with alcohol

25

What are some examples of weak opioids used to treat pain?

Co-codamol

Tramadol

26

What are some examples of strong opioids?

Morphine

Oxycodone

27

What are some opioid side-effects?

N&V

Constipation

Sedation

28

What are some adjuvant drugs which can be used to treat chronic pain?

Anti-depressants (amitriptyline, duloxetine)

Anti-convulsants (carbamazepine, gabapentin, pregabalin)

 

29

Name a

a) tricyclic antidepressant

b) anticonvulsant

c) selective serotonin reuptake inhibitor (antidepressant)

which can be used as an adjuvant analgesic?

a) Amitriptyline

b) Carbamazepine, gabapentin, pregabalin

c) Duloxetine

30

Which analgesics can be applied topically and don't affect the brain itself?

NSAIDs

Capsaicin

Lidocaine (local anaesthetic)