Lecture 20 - Gentile - Opioids Flashcards
(52 cards)
What 4 areas of the brain are activated in acute pain?
Insula, Anterior Cingulate, Thalamus, and Basal Ganglia
Which regions are involved in anticipating and perceiving pain?
Brain stem and descending pain modulatory system
Chronic pain leads to increasing activation of which brain region?
Pre-frontal cortex
Define excitatory neurotransmitters and name 2 of them
They are inflammatory chemicals that are released after tissue is damaged
Histamine and Bradykinin
What does Bradykinin do?
Stimulates release of prostaglandins and substance P, a potent neurotransmitter that enhances movement of impulses
Most opioids act on the ___
Synapse
What cortex identifies the location and intensity of pain?
Somatosensory cortex
What cortex determines how an individual interprets the meaning of pain?
Associated Cortex
Acute vs Chronic Pain
Acute pain is a normal response that can be beneficial (signal damage or warn of harm) and will disappear once the cause is treated
Chronic pain persists and is no longer beneficial
How do you manage pain for acute vs chronic?
Acute - reduce the pain by treating the cause
Chronic - can only reduce pain
The most successful way to treat pain is ____
Opioids!
What are the 4 types of opioid receptors?
Delta, Kappa, Mu, and Nociceptin receptor
Where is the Mu receptor found?
Brain, Spinal Cord, and Intestinal Tract
What are the functions of the delta receptor?
Analgesia, antidepressant, and physical dependence
Define Analgesia
Absence of pain without loss of consciousness
What does physical dependence refer to?
Chronic use of drug has produced tolerance
What are the functions of the kappa receptor?
Spinal analgesia, sedation, miosis, inhibition of ADH release, dysphoria
What is miosis?
Constriction of the pupil to less to 2 mm
What is dysphoria
The opposite of euphoria
What are 2 methods to reduce the amount of action potentials generated pre-synaptically?
Reduce the amount of neurotransmitter released (inhibit ca entry via ca channels) or hyperpolarize membrane via stimulating k channel and inc k+
How would you shut down neurotransmission post-synaptically
K+ channel stimulation
IPSP
What opioid receptors are seen pre-synaptically? post-synaptically?
pre-synaptically = mu, kappa, and delta
post-synaptically = mu
How do opiates work?
Inhibit LC neurons via activating K+ channels and inhibiting Na+ dependent inward current (thru inhibition of cAMP via G protein)
What is the most important side effect of opioids?
Respiratory Depression
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