Non-opioid Analgesics Flashcards

(33 cards)

1
Q

What is local inflammation?

A

The body’s response to an injury

  • ID the injury
  • remove noxious materials
  • ward off infection
  • repair damage to tissue/restore function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Injured cells release what?

A

Alarmins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F - pathogens can sneak through an injury site?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Alarmin Il-33 can produce what?

A

Degranulation of mast cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Histamine

A

One of the more important initial mediators of the inflammatory response released by mast cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does Histamine act?

A

Through a GPCR to produce vasodilation and render the capillaries ‘leaky’
This allows more immune cells to enter the injury site and produce edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Histamine-H1 receptors activity

A

Increase intracellular Ca to produce two major effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What two major effects are the result of the increase of intracellular Ca by Histamine-H1 receptor activity?

A

1) NO mediated relaxation of smooth muscle, causing vasodilation
2) MLCK mediated contraction of the capilary endothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does MLCK mediated contraction of the capillary endothelium cause?

A

It makes the capillaries leaky

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

As more immune cells are recruited to the injury site, what happens?

A

The inflammatory response is ramped up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What role does inflammation play in nociceptive pain?

A

Inflammatory mediators interact with receptors and facilitate the transmission of pain signals throughout the nervous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the major inflammatory mediators that can cause pain?

A
Prostaglandins
Substance P
TNF-a
IL-16
IL-6
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F - Local inflammation adds to the pain felt at the injury site

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F - Excessive inflammation is not beneficial to the host

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What’s the goal of anti-inflammatory drugs?

A

Attenuate the inflammatory response

Attenuate pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The anti-inflammatory properties and pain relief comes from what?

A

Attenuating the production of prostaglandins

17
Q

What are prostaglandins synthesized from?

A

Arachidonic acid

18
Q

What are the principle prostaglandins?

A

PGE2
PGD2
PGF2
PGI2

19
Q

What do Cox1 and Cox 2 do?

A

They send arachadonic acid down the path leading to the production of prostaglandins

20
Q

How do prostaglandins enhance pain sensitization?

A

They activate Gas, which increases PKA activity, which phosphorylates TRP nociceptors - enhancing pain sensitization

21
Q

How do NSAIDs wrk?

A

Inhibiting COX enzymes, diminishing the production of prostaglandins

22
Q

What is acetylsalicylic acid’s (asprin) mechanism of action?

A

Irreversible inhibitor of Cox1 and Cox2

About 100x better inhibitor of Cox1

23
Q

What is Ibuprofen, Naproxen, and Acetaminophen’s mechanism of action?

A

Reversible inhibitors of Cox1 and Cox2

Naproxen are most selective for Cox2

24
Q

What are the therapeutic effects of acetylsalicylic acid?

A

Analgesia
Antipyretic (fever)
Anti-inflammatory
Anti-thrombolytic (clotting)

25
What are the therapeutic effects of ibuprofen and naproxen?
Analgesia Antipyretic (fever) Anti-inflammatory
26
What are the therapeutic effects of acetaminophen?
Analgesia | Antipyretic (fever)
27
Why is acetylsalicylic acid able to produce anti-thrombosis?
Because it is an irreversible inhibitor of the Cox enzymes, knocking out ALL enzyme activity
28
Why is acteaminophen not an anti-inflammatory?
Several possibilities 1) Unique Cox enzyme in the CNS is the target 2) Acetaminophen's mechanism is different 3) Provides relief through an entirely different mechanism (cannabinoid receptor)
29
How can NSAIDs disrupt mucosal defense in the stomach?
Prostaglandins (primarily from Cox1) stimulate mucus and bicarbonate secretion to help make the 'mucus gel' protecting the stomach from digesting itself
30
What are some adverse affects of NSAIDs
``` Decreased mucosal stomach defense Increases bleeding time (acetylsalicylic acid) Kidney problems Increased BP Heart failure (rare) ```
31
What are some precaustions and contraindications for acetylsalicylic acid
Ulcer Diabetes Gout Hypocoagulation conditions
32
What is important to know for combining opioids and non-opioid pain relievers?
It can be done NSAIDS have a ceiling effect - maximum pain relief achieved is higher for opioids They work by different mechanisms
33
What is the most effect analgesia?
Optimum dose of NSAID and an additional opioid