analgesia

Answer 1

Question: Can you tell me about Ibuprofen, Diclofenac, Naproxen, and Ketorolac?
Answer:

Class: Non-selective NSAIDs

Mechanism:

Reversibly inhibit COX enzymes (COX-1 and COX-2)

COX-1: Responsible for platelet aggregation and GIT protection

COX-2: Involved in inflammation, fever regulation, and pain sensitization

Use:

Pain relief (acute headache, migraine, rheumatic disorders, musculoskeletal pain)

Anti-inflammatory (reduces prostaglandin production)

Antipyretic (reduces fever)

Side Effects:

Common: GIT disorders, bronchospasms (don’t use in asthmatic patients), peptic ulcers

Serious: Can cause bronchospasms due to COX-1 inhibition, increasing risk in those with asthma

Important: Avoid use in asthmatic patients due to bronchoconstriction risk

Answer 2

Question: Can you tell me about Celecoxib and Etoricoxib?
Answer:

Class: Selective NSAIDs (COX-2 inhibitors)

Mechanism:

Selectively inhibit COX-2 (less action on COX-1)

Reduces GI side effects associated with COX-1 inhibition

Use:

Used for pain and inflammation relief in osteoarthritis and rheumatoid arthritis

Side Effects:

Common: Dizziness, headache, palpitations, arrhythmias, hypertension

Important: Should be prescribed with a proton pump inhibitor (PPI) to protect the GI tract

Answer 3

Question: Can you tell me about Paracetamol (Acetaminophen)?
Answer:

Class: Analgesic, Antipyretic

Mechanism:

Inhibits prostaglandin synthesis in the CNS, acting mainly on COX enzymes found in the brain (not in peripheral tissues)

Use:

Effective for headache and acute migraine

Side Effects:

Common: Generally well-tolerated but can lead to liver toxicity in overdose

Note: Does not have anti-inflammatory properties

Answer 4

Question: Can you tell me about Prochlorperazine?
Answer:

Class: Anti-emetic

Mechanism:

Blocks D2 receptors in the brain

Use:

Treats nausea and vomiting associated with migraine

Side Effects:

Common: Constipation, dizziness, drowsiness, dry mouth, weight gain, hypotension

Answer 5

Question: Can you tell me about Tegaserod (Tegaserod 10 mg)?
Answer:

Class: Anti-emetic

Mechanism:

Inhibits D2 and serotonin 5-HT3 receptors

Use:

Used for the symptomatic treatment of nausea and vomiting associated with acute migraine

Side Effects:

Common: Depression, diarrhea, drowsiness, hypotension

Answer 6

Question: Can you tell me about Sumatriptan?
Answer:

Class: Triptans (Selective Serotonin Agonist, SSA)

Mechanism:

Selective agonist for serotonin (5-HT) receptors, leading to vasoconstriction of cranial blood vessels and inhibition of pro-inflammatory neuropeptide release

Modulates the trigeminal nerve, helping to alleviate migraine symptoms

Use:

First-line treatment for acute migraine and acute cluster headache

Side Effects:

Common: Dizziness due to vasoconstriction and changes in cerebral blood flow

Answer 7

uestion: Can you tell me about Amitriptyline?
Answer:

Class: Tricyclic Antidepressants (TCAs)

Mechanism:

Blocks the reuptake of norepinephrine (NE) and serotonin in presynaptic terminals, enhancing their availability in the synaptic cleft

Involved in regulating blood vessels and reducing inflammation

Use:

Migraine prophylaxis, chronic musculoskeletal pain, chronic tension-type headaches

Side Effects:

Common: Anticholinergic effects (dry mouth, blurred vision), drowsiness, QT prolongation

Answer 8

uestion: Can you tell me about Candesartan?
Answer:

Class: Angiotensin Receptor Blockers (ARBs)

Mechanism:

Blocks the angiotensin II receptor, reducing blood pressure

Use:

Migraine prophylaxis

Side Effects:

Common: Cough, diarrhea, dizziness

Answer 9

Question: Can you tell me about Propranolol?
Answer:

Class: Beta-blockers

Mechanism:

Blocks beta-adrenergic receptors, reducing heart rate and blood pressure

Use:

Migraine prophylaxis

Side Effects:

Common: Depression, diarrhea, dizziness, dry ey

Answer 10

Question: Can you tell me about Flunarizine?
Answer:

Class: Calcium Channel Blockers

Mechanism:

Inhibits calcium entry into cells, affecting vascular smooth muscle and neurotransmission

Use:

Migraine prophylaxis

Side Effects:

Common: Weight gain

Answer 11

Question: Can you tell me about Topiramate?
Answer:

Class: Anticonvulsant

Mechanism:

Increases GABA activity and inhibits glutamate activity, reducing neuronal excitability

Use:

Migraine prophylaxis

Side Effects:

Common: Constipation, cough, depression, dizziness, drowsiness, dry mouth

Answer 12

Question: Can you tell me about Erenumab?
Answer:

Class: CGRP Monoclonal Antibody

Mechanism:

Blocks the calcitonin gene-related peptide (CGRP) receptors, which are involved in pain transmission

Helps prevent migraine attacks by lowering CGRP levels during an attack

Use:

Migraine prophylaxis (for 4+ migraines/month)

Side Effects:

Common: Angioedema, constipation, hypersensitivity, muscle spasms, oedema, skin reactions, swelling