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Neurology Year 3 > Analgesia > Flashcards

Flashcards in Analgesia Deck (44)
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1

Drugs that reduce pain at the site of injury do so how?

Decreases sensitisation by blocking's prostaglandin synthesis

2

Give a example of a drug that reduces pain at the site of injury?

NSAIDs

3

Drugs that reduce nerve conduction of pain do so how?

Block of voltage gates Na+ channels

4

Give an example of drugs that reduce the nerve conduction to reduce the perception of pain?

Lignocaine

5

List some drugs that reduce the synaptic transmission in the dorsal horn.

Opiods
Some antidepressants

6

List drugs which activate the descending inhibitory controls.

Opiods
Select tri-cyclic antidepressants

7

Which drugs target the ion channels that are unregulated in nerve damage?

Antiepileptics e.g. GABA pentinoids

8

List some common NSAIDs

Aspirin
Diclofenac
Ibuprofen
Naproxene

9

List some weak opiods

codeine
tramadol
dextropropoxyphene

10

List some strong opiods

Morphine
oxycodone
fentanyl
heroin

11

In supra spinal antinociception where do the neurones arise from?

Peraqueductal grey mater
Locus coeruleus
Nucleus Raphe Magnus

12

Where do neurones of the supra spinal anti-nociception project down to?

Posterior horn to the area where the 1st and 2nd order neurones of the spinothalamic tract synapse.

13

The supra spinal antinociception neurones release what into the synapse?

Noradrenaline
5 HT (Seretonin)

14

Noradrenaline and 5 HT have what affect of the spinothalamic tract?

Inhibits the release of Substance P from presynaptic build.
Prevents Depolarisation on the Second order neurone.

15

What affect does Noradrenaline and 5HT have on the interneurone located by the synaptic cleft of the 1st and 2nd order neurone?

Interneurone is activated and releases Enkephalin (Opiod)

16

What is the affect of Enkephalin?

Prevents depolarisation of the presynaptic bulb and the sport synaptic neurone.

17

What kind of receptors do opioids work on?

G protein Coupled Receptors

18

What is the affect of activating a opioid G protein coupled receptor?

Beta unit - Inhibition of Ca2+ channels suppress excitatory neurotransmitter release.
- opening K+ channels suppressing excitation by hyper-polarising the neurones.
Inhibiting adenyl cyclase - long term suppression

19

What are the different types of opioid receptors and what are there functions?

μ - most analgesic action and major sideaffects
δ - activation can be proconvulsant
k - Sedation dysphoria and hallucination

20

List the major respiratory side effects of Opioids.

Apnoea - medullary respiratory system becomes desensitised to CO2 levels

21

List the major cardiovascular side effects of Opioids

Orthostatic hypotension - reduced sympathetic tone and bradycardia
Histamine mediated dilation

22

List the major GI side effects of Opioids.

Nausea Vomiting Constipation
-acts on the CTZ

23

List the major CNS side effects of Opioids.

Confusion Euphoria Dysphoria hallucinations Dizziness Myoclonus Hyperalgesia

24

Morphine

Acute and Severe pain
Metaboised in liver
IV IM SC or oral

25

Diamorphine

Severe post operative pain
More lipophilic than morphine
Rapid onset when IV
Heroin

26

Codeine

Mild moderate pain
Anti diarrhoea Antitussive (prevent cough)
Oral

27

Fentanyl

75x more potent than morphine
IV to provide analgesia in maintenance anaesthesia
Transdermal or buccal in chronic pain

28

Pethidine

Acute pain especially labour
Rapid onset IV IM or SC - short duration
Should be given with MAO inhibitors

29

Buprenophine

Useful in chronic pain with patient controlled injection system
Slow onset but long duration of action

30

Tramadol

Weak μ agonist
Oral
Avoid in patients with epilepsy