T1L24 analgesics, anaesthetics and sedatives Flashcards
pain def
an unpleasant sensory and emotional experience associated with actual or potential tissue damage
whatever the patient says
gate theory
C fibres let pain through
Ab fibres stimulate inhibitory neurons
3 ways of pain modification
- nociceptor C, Adelta fibres
- central interpretation
- drugs
ladder of analegesics
- NSAIDs/paracetalmol
- weak opiates/local anaesthetics
- strong opiates
s14/15
opioids
types
administration
where are receptors
receptor subtypes
- act on opioid receptor
- naturally occurring (morphine, codeine)
- semisynthetic eg diamorphine
- synthetic eg fentanyl
administration:
- IV
- intramuscular
- oral
- intranasal/aerosol
- epidural/spinal
receptors:
- pons and midbrain
- periaqueductal grey matter
- nucleus raphe magnus
- spinal chord posterior horn
- GIT
- peripheral tissues
subtypes:
OP3, OP2, OP1
morphine side effects
- resp depression
- nausea and vomiting
- constipation
- miosis
ketamine
- NMDA receptors
- Kappa and delta receptors
- local/general analgesic
- anaesthetic
- sedative
- side effects
NSAIDS
- inhibit cyclooxygenase 1 and 2
- analgesic, antipyretic, anti-inflammatory
side effects:
- gastric irritation
- bronchospasm
- renal impairment
- platelet function (aspirin)
aspiring
NSAID
- oxidative phosphorylation
- air hunger
- reyes syndrome
paracetamol
- unknown mechanism
- overdose hepatotoxicity
- N acetylcysteine
antiemetics
stop vomiting and nausea
- Propofol
- steroids
- cannabinoids
ramsey sedation scale
- patient anxious
- cooperative
- responds only to commands
- brisk response to shout
- sluggish response
- no response
benzos
eg diazepam
enhance GABAa and b
side effects:
- oversedation, loss of airway
- respiratory depression
-
2 classifications of local anaesthetics
mechanism
adminsitration
- amides eg lignocaine
- esters eg cocaine
Na channel blockade, thus blocking action potential
administration:
- spinal epidural caudal
- skin
- nebulised
lecture slides are shit mate x
