Acute And Chronic Analgesic Drugs

Question 1

Opioid receptos sub-types

Answer 1

μ (mu)
k (kappa)
δ (delta)

Question 2

Examples of opioids

Answer 2

Morphine
Pethidine 
Methadone 
Buprenorphine 
Butorphanol 
Fentanyl 
Alfentianil

Question 3

pure μ agonists

Answer 3

Morphone, methadone and pethidine

Question 4

partial μ agonist

Answer 4

Buprenorphine

Question 5

k agonist and a μ antagonist

Answer 5

Butorphanol

Question 6

Opioid that can’t be given IV

Answer 6

Pethidine

Question 7

Requirements of an opioid drug to enable it to be given epidutally

Answer 7

Preservative-free or preservatives are not neurotoxic

Question 8

Opioid metabolism and excretion

Answer 8

Metabolised by the liver and excreted in the urine

Question 9

Opioids commonly used for pre-medication

Answer 9

Buprenorphine, methadone and butorphanol

Question 10

How NSAIDs work

Answer 10

Blocking Cyclo-oxygenase enzymes (COX)

Question 11

COX enzymes convert arachidonic acid to:

Answer 11

Prostoglandins

Question 12

Accumulation of prostoglandins reaction

Answer 12

Red, swollen, warm and painful tissues

Question 13

Uses for NSAIDs other than analgesia

Answer 13

Anti-inflamatory
Anti-pyretic (decreases body temperature)
Anti-endotoxaemic

Question 14

NSAIDs should not be used in these cases

Answer 14

• When a sterioid has been used
• In renal failure
• In cases of hypovolaemia
• When an animal is hypotensive
• Evidence of gastro-intenstinal ulceration, vomiting or diarrhoea
• Animals with a clotting dysfunction

Question 15

Why do NSAIDs have an effect on clotting?

Answer 15

Thromboxane A2 a factor which helps in clotting is blocked by NSAID administration

Question 16

Which part of the pain pathway to NASIDs affect?

Answer 16

Transduction

Question 17

Which part of the pain pathway do Alpha 2 adrenergic agonists affect?

Answer 17

Modulation and Perception

Question 18

How Alpha 2 adrenergic agonists are handled by the body

Answer 18

Metabolised in the liver and excreted in the urine

Question 19

Routes of administration for Alpha 2 Adrenergic agonists

Answer 19

IV, IM, SC
Epidural route
Can be absorbed by mucous membranes

Question 20

Ketamine mode of action to produce analgesia

Answer 20

An antagonist at NMDA (N-methyl D-aspartate) receptors which are involved in the development of central sensitisation

Question 21

Type of pain Ketamine is most useful against.

Answer 21

Somatic pain

Question 22

Analgesic drugs that can produce a total absence of pain

Answer 22

Local anaesthetics

Question 23

Local anaesthetics work on which part of the pain pathway

Answer 23

Transmission

Question 24

How do local anaesthetics work?

Answer 24

To stop the transmission of electrical impulses along nerves by blocking the sodium channels in the nerve fibres

Question 25

Examples of local anaesthetic drugs

Answer 25

- Lidocaine - Bupivicaine - Ropivacaine - Mepivacaine - Procaine

Question 26

Two subdivisions of local anaesthetics

Answer 26

Amide Linked group | Ester Linked Group

Question 27

Local anaesthetics belonging to the Amide Linked Group

Answer 27

- Lidocaine - Bupivacaine - Mepivacaine - Ropivacaine

Question 28

How are Amide Linked local anaesthetics handled by the body?

Answer 28

Metabolised by the liver

Question 29

The only local anaesthetic that can be administered intravenously

Answer 29

Lidocaine

Question 30

Local anaesthetics belonging to the Ester linked group

Answer 30

Procaine

Question 31

How are Ester linked group local anaesthetics managed by the body?

Answer 31

Broken down in the blood by enzymes

Question 32

Duration and onset of action for lidocaine

Answer 32

5-10 minutes onset | Last up to 1 hour

Question 33

Duration and onset of action for Bupivacaine

Answer 33

30 minute onset | 6-8 hour duration

Question 34

Local anaesthetic that produces less motor blockade than others

Answer 34

Ropivacaine

Question 35

How can maropitant produce analgesia?

Answer 35

Creates visceral analgesia by antagonising the NK1 receptors

Question 36

Non pharmaceutical methods of pain management

Answer 36

- Providing a comfortable environment - correct temperature, quiet, comfortable bedding - Adequate nutritional support to aid wound healing - encourage normal sleeping patterns with light and dark times - grooming, TLC and quality time - Gentle physiotherapy - massage, hot and cold packs, passive range of motion exercises - support of fracture with bandages/sprints and wound dressings - ensuring an empty bladder and bowels

Question 37

What does galliprant target

Answer 37

Works as an antagonist at the EP4 receptor for PGE2 | - can provide analgesia for osteoarthritis without affecting other enzymes

Question 38

What does bedvetinmab (librealla & Solensia) target?

Answer 38

Contains monoclonal antibody (mAb) which targets nerve growth factor (NGF)

Question 39

Paracetamol action

Answer 39

Non-acidic NSAID which acts at the level of the spinal chord COX enzymes, the opioid, serotoninergic and cannabinoid systems

Question 40

Dose rate for paracetamol

Answer 40

10mg/kg IV | Up to 30mg/kg PO BID or TID

Question 41

Mechanism of Gabapentin and Pregabalin

Answer 41

Binding to calcium channels in the CNS, reducing the production of pro-nociceptive inputs and facilitating descending inhibitory pathways

Question 42

Tramadol mechanism

Answer 42

works at the µ opioid receptors, 5HT receptors and noradrenaline receptors.

Question 43

NMDA Antagonist

Answer 43

Amantadine

Question 44

Additional therapies added to pain management plans

Answer 44

Acupuncture | Physiotherapy