NSAIDS Flashcards

0
Q

Somatoscisation

A

Emotional pain causing physical pain

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1
Q

Define pain

A

Unpleasant sensory and emotional experience which we primarily associate with tissue damage or describe in terms of such damage, or both

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2
Q

Name the 3 components of pain

A

Sensory discriminatory comp
Motivational- affective comp
Cognitive- evaluative comp

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3
Q

Describe the steps in feeling pain

A
Receptor activation (noiciceptors)
Mediated by A-delta & C fibres
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4
Q

Describe A delta fibre

A

Thin, quick

Sharp localised pain

Withdraw hand

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5
Q

Describe C fibres

A

Thick, myelinated

Dull throbbing pain

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6
Q

Name NTs involved in pain pathways/ modulation/ transmission

A
Substance P
Serotonin
Histamine
ACh
Glutamate
NA
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7
Q

What do endorphins regulate?

A

Regulate response to pain and stress

Endogenous opioid

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8
Q

What is somatic pain

A

Can localise pain

Usually involves organs/ systems

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9
Q

Describe somatic pain sensations

A

Aching, squeezing, stabbing, throbbing

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10
Q

What axons are activated in somatic pain?

A

Primary sensory afferents

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11
Q

What is stimulated in visceral pain?

A

Afferent receptors located in the viscera

Ill defined, cramping, gnawing, can be referred

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12
Q

Where can biliary referred pain be felt?

A

The shoulder

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13
Q

Name some NTs that are inflammatory mediators

A

Substance P
Serotonin
Bradykinin
Histamine

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14
Q

What is the role of prostaglandins in inflammation?

A

Enhances noiciceptive response to inflammation by lowering threshold to noxious stimuli

Causes to pain!

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15
Q

Why do NDAIDs inhibit to produce an analgesic affect?

A

Acharonic acid ➡️prostaglandins

16
Q

What enzyme does paracetamol inhibit?

A

COX 2

Perhaps COX 3

17
Q

What is arachidonic acid synthesised from?

A

Membrane phospholipids

18
Q

What is produced by paracetamol metabolism that causes liver toxicity?

A

NAPQI

19
Q

What is the antidote to paracetamol & what does it mop up?

A

Glutathiol

Mops up NAPQI

20
Q

What is the affect of aspirin in low doses?

A

Inhibits COX1 in platelets

Anti- platelet activity

21
Q

Aspirin high dose

A

COX 1 & 2

Anti platelet & anti inflammatory

22
Q

Name 3 NSAIDs

A

Diclofenac
Indomethacin
Ibuprofen

23
Q

The risk of what is significantly increased in Aspirin & NSAID combined use?

A

Gastric bleed

24
Q

What is given to reduce chance if GI bleed in patients taking aspirin and NDAIDs?

A

H2 antagonists

Proton pump inhibitor

Reduce acid production in stomach

25
Q

Name 2 COX 2 inhibitors (COXIBs)
And the effects!
What adverse effect are you more likely to experience?

A

Celecoxib
Etoricoxib
Anti inflammatory effects, no GI effects
But takes COX 1 route, ⬆️ platelet aggregation = stroke/ MI