Flashcards in Exam #01c - Pain Deck (22):
True or False - sensation of acute pain should not be eliminated, while sensation of chronic pain should be eliminated?
True - chronic pain is deleterious to quality of life (QoL)
The optimal therapy for pain involves matching what with what?
The analgesic MOA with the type(s) of pain
Pain pathways involve pain signals traveling to the spinal cord via what (2) nerve fibers? What type of pain does each carry?
1. A-delta - sharp pain
2. C fibers - dull, burning pain
Which pain pathway nerve fiber carries the pain signal to the spinal cord faster than the other? Why?
A-delta fibers carry sharp, specific pain to the spinal cord faster b/c they are thicker and thinly sheathed in a insulating material (myelin) compared to the unmyelinated C-fibers
Where do A-delta and C fibers synapse on second order neurons in the spinal cord (after entering the dorsal root ganglion)?
What part of the brain allows us to located where pain is coming from?
Which type of pain is due to a stimulus that does not normally provoke pain (i.e. a non-noxious stimulus)?
Allodynia - no nociceptor activation
Which type of pain has matching presynaptic and postsynaptic activity?
Which type of pain is an inappropriate excess response to a pain stimulus?
Which type of pain involves the pain getting amplified when you allow pain to persist?
Which pain is easy to diagnose, but difficult to treat b/c of a huge psychological component often correlating to physical or mental abuse?
Compare the SOA for NSAIDs, LA's, and opioids?
NSAIDs work at site of injury in the periphery
LA's work at the primary afferent neuron
Opioids work in the CNS
What are the (5) types of analgesics used to treat nociceptive pain?
NSAIDs have which of the following properties:
A) rapid onset
C) inhibits COX-1
D) lacks CNS effects of opioids
NSAIDs have all of those properties
What (2) ways can you develop APAP hepatoxicity when taking APAP?
2. excess alcohol
Which receptor type do opioids primarily work through to deliver analgesia?
mu GPCR's (inhibitory, Gi)
True or False - Tramadol is a centrally acting analgesic with NO peripheral effect?
Why is it said that Tramadol is multi-modal with a dual MOA?
Tramadol has (2) enantiomers which activate mu opioid receptors (from metabolite, mu agonist) and nonopioid receptors (inhibiting reuptake of NE and 5-HT)
True or False - Tramadol and Tapentadol are considered NSAIDs?
Tapentadol also has a dual MOA like Tramadol. How is Tapentadol's MOA different?
Tapentadol still inhibits the afferent pain signal by being a mu opioid agonist, but different than Tramadol in that it is only a NE reuptake inhibitor (and not 5-HT as well)
True or False - Patients tend to dose themselves with less opioid when using PCA (patient controlled analgesia) rather than healthcare professionals controlling it?