Module 6 Pain

Question 1

Define pain

Answer 1

Unpleasant sensory and emotional experience that is associated with actual or potential tissue damage

Question 2

What is considered chronic pain

Answer 2

This is pain that is no longer associated with normal tissue healing processes and persists beyond tissue healing

Question 3

What is considered acute pain

Answer 3

Pain that has a short duration lasting less than 6 weeks

Question 4

What is nociceptive pain

Answer 4

This is pain that is associated with damage to non neuronal tissue and is triggered by activation of nociceptors

Question 5

What is neuropathic pain

Answer 5

This is bain that is caused by a lesion to the somatosensory NS e.g. compression of a nerve

Question 6

What is neoplastic pain

Answer 6

This is pain despite no clear evidence of actual or threatened tissue damage

Question 7

How is visceral nociceptive pain described

Answer 7

Squeezing or clamping pain thay is poorly localised and is disfuse

Question 8

What is somatic nociceptive pain described as

Answer 8

Sharp dull aching pain that can be localised

Question 9

What is neuropathic pain described as

Answer 9

It is burning electrical shocks and causes pain when even in ways that do not normally cause pain

Question 10

Hyperalgesia

Answer 10

This is increased pain to stimuli that normally cause pain

Question 11

What is allodynia

Answer 11

This os pain that is stimulated by factors that do not normally cause pain

Question 12

What is the general treatment for chronic pain

Answer 12

1. Gabapentinoids
2. Low dose tricyclic antidepressants
3. SNRI

Question 13

What are considered simple analgesics

Answer 13

1. Paracetamol
2. Asprin
3. NSAIDs

Question 14

What is considered a weak opioid

Answer 14

1. Tramadol
2. Codeine
3. Dihydrocodeine

Question 15

What are considered strong opioids

Answer 15

Morphine
Oxycodone
Fentanyl

Question 16

What are 4 examples of NSAIDs

Answer 16

1. Ibuprofen
2. Diclofenac
3. Indomethacin
4. Ketorolac

Question 17

What are the serious complications that can occur from NSAIDs

Answer 17

Bronchospasms

Question 18

What are the weak opioids

Answer 18

1. Codeine
2. Tramadol

Question 19

What is the long acting opioid

Answer 19

Morphine

Question 20

What are the short acting opioids

Answer 20

1. Fentanyl
2. Remifentanil

Question 21

Which opiod can cause histamine release

Answer 21

Morphine

Question 22

What is the mechanism of action of naloxone

Answer 22

Opioid antagonist

Question 23

What are the 3 main side effects of naloxone

Answer 23

1. Arrythmias
2. PE
3. Hypertension

Question 24

What are the 3 main reseptors that opiods bind to

Answer 24

MOP, DOP and KOP

Question 25

Which reseptor do most opiods act on

Answer 25

MOP

Question 26

What are the 4 main benefits of opioids in anaesthesia

Answer 26

1. They have centrally mediated analgesic effects 2. Cause sedation 3. They decrease sympathetic firing 4. Cough suppression

Question 27

Which opioid is used to dampen the intubation response

Answer 27

Alfentanil

Question 28

Which drug is given as a prodrug and is then metabolised into morphine

Answer 28

Codeine

Question 29

What are the 2 synthetic and semi synthetic opioids

Answer 29

Synthetic: Heroin Oxycodone Semi synthetic: Pethidine Fentanyl

Question 30

What is the benefit of Alfentanil in pregnancy

Answer 30

It does not cross the placenta

Question 31

What is the onset and offset of Alfentanil

Answer 31

5 mins

Question 32

What is the is the most potent form of fentanyl

Answer 32

Sufentanil

Question 33

WHat is the most short acting opiod

Answer 33

Remifentanil

Question 34

What are the indications for remifentanil

Answer 34

>Sleep apnea >morbid obesity >Avoiding post operative resp depression >Deep intraoperative analgesia is required

Question 35

Which drugs are considered the non selective NSAIDS 3

Answer 35

Ibuprofen Diclofenac Ketorolac

Question 36

What are the 2 selective COX 2 inhibitors

Answer 36

Celecoxib Parecoxib