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Pharmacology Y2 > Pain > Flashcards

Pain Flashcards

(65 cards)

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1
Q

List 5 causes of pain

A

Inflammation
Neuropathy
Headache
Central pain (spinal cord injuries)
Cancer pain (tissue and nerve damage)

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2
Q

Which system of the brain attaches emotions to pain?

A

Limbic system

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3
Q

List 7 co-morbidities associated with pain

A

Difficulty sleeping
Lack of energy
Drowsiness
Difficulty concentrating
Anxiety
Poor appetite

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4
Q

Does the brain have pain sensors?

A

No, it is the only part of the body without pain sensors

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5
Q

What is nociceptive pain?

A

Pain from damaged non neural tissue, which activates nociceptors

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6
Q

Give an example of nociceptive pain

A

Lower back pain

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7
Q

What is neuropathic pain?

A

Pain caused by a lesion or disease of the somatosensory nervous system

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8
Q

Give 2 examples of neuropathic pain

A

Carpal tunnel syndrome
Trigeminal neuralgia

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9
Q

What is nociplastic pain?

A

Pain from nociceptors but no evidence of lesion of tissue damage

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10
Q

Give an example of nociplastic pain

A

Fibromyalgia

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11
Q

What are 6 factors that aid the transduction of pain from receptors?

A

5HT
Capsaicin
H+
Substance P
Prostaglandins
Na+ and Ca2+ channels

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11
Q

What are 6 factors that aid the transduction of pain from receptors?

A

5HT
Capsaicin
H+
Substance P
Prostaglandins
Na+ and Ca2+ channels

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12
Q

What receptors do Triptans target to block transduction of pain?

A

TRPV receptors that respond to heat - capsaicin

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13
Q

What receptors do CGRP antibodies target to block transduction of pain?

A

Substance P receptors that respond to mechanical stimulus

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14
Q

What receptors do NSAIDS target to block of pain?

A

Prostaglandin receptors that respond to cold stimulus

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15
Q

Why are NSAIDs always useful in treating pain?

A

NSAIDs reduce inflammation, and inflammation will always be a component of pain

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16
Q

What receptors does lidocaine target to block the transduction of pain?

A

Na+ and Ca2+ channels

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17
Q

Why is lidocaine not always useful?

A

It is non specific so may have other side effects as well as blocking pain

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18
Q

Give 2 examples of NSAIDs

A

Aspirin
Ibuprofen

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19
Q

Name the specific receptors that NSAIDs block

A

COX1
COX2
Cyclo-oxygenase

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20
Q

Why should patients be wary of stomach problems when taking ibuprofen?

A

Prostaglandins help production of stomach mucus, so blockage of this will make the stomach more susceptible to damage from stomach acid

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21
Q

Why does paracetamol function as an effective painkiller?

A

It targets receptors in the spinal cord and the brain

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22
Q

What is a negative factor of paracetamol?

A

It is metabolised quickly by the liver so has a narrow therapeutic window

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23
Q

Which pain blockers are effective for migraines?

A

Triptans
CGRP antibodies

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24
Define hyperalgesia
More pain in response to a pain stimulus
25
Define allodynia
Over sensitivity of pain fibres resulting in pain from a non painful source
26
Name 2 calcium channel blockers that block the release of neurotransmitter
Gabapentin Pregebalin
27
Name a potassium channel opener that increases outward currents of K+
Opioids
28
Name 2 sodium channel blockers that block the inward currents of Na+
Lidocaine Carbamazepine
29
What is the disadvantage of taking calcium channel blockers for pain relief in the long term?
Can cause low blood pressure, resulting in negative effects on the heart - not good for the long term
30
Why is it advantageous to use NA+ blockers rather than Ca2+ blockers for pain?
There are many different specific Na+ channels, so easier to target specific channels for specific pain relief
31
Which Na+ channels are specific to C fibres?
NaV. 1.7+1.8
32
What happens to C fibres when they have repeated input?
It increases their sensitivity so they are hyper responsive to pain
33
Why does repeated input increase C fibre sensitivity?
The Mg2+ ion that blocks NMDA receptors is removed
34
What drug can be used to prevent increased C fibre sensitivity?
Ketamine
35
How does Ketamine prevent increased C fibre sensitivity?
It blocks the NMDA channels
36
What is brainstem analgesia?
When in a fight or flight response the PAG is activated so that pain is not detected at that time
37
How can mood affect pain?
Depressed patients complain of pain, they are linked
38
What is the mechanism of action of heroin?
It penetrates into the CNS and loses its acetyl groups, becoming morphine
39
On which receptors does heroin act on?
G protein coupled receptors
40
Where are the majority of receptors located which heroin acts on?
In the PAG In the substantial gelatinosa
41
Which channels are opened by morphine and heroin?
K+ channels
41
Which channels are opened by morphine and heroin?
K+ channels
42
Name the 4 opioid receptors
Mu Kappa Delta ORL-1
43
What is the natural neurotransmitter for Mu opioid receptors?
Endomorphins
44
What is the natural neurotransmitter for Delta opioid receptors?
Enkephalins
45
What is the natural neurotransmitter for Kappa opioid receptors?
Dynorphin
46
What is the natural neurotransmitter for ORL-1 opioid receptors?
Nociceptin
47
Name 2 drugs that act on Mu opioid receptors
Morphine Pethidine
48
Name a drug that acts on Delta opioid receptors
DPDPE
49
Name a drug that acts on Kappa opioid receptors
U50488H
50
Which 3 opioid receptors conduct the opening of K+ channels?
Mu Delta ORL-1
51
Which opioid receptor conducts closure of Ca2+ channels?
Kappa
52
Name 2 pro drugs fro morphine
Heroin Codeine
53
Which opioid is used for surgical procedures?
Fentanyl
54
What is an antagonist for opioid receptors?
Naloxone
54
What is an antagonist for opioid receptors?
Naloxone
55
Which fibres are not affected by opioids?
Alpha beta fibres
56
Can you still feel pain if alpha beta fibres are not inhibited?
No, you will be able to feel touch but not pain
57
How do opioid affect pre synaptic receptors?
They inhibit release of glutamate and peptide neurotransmitters
57
How do opioid affect pre synaptic receptors?
They inhibit release of glutamate and peptide neurotransmitters
58
How do opioids affect post synaptic receptors?
They hyper polarise the output neurone
58
How do opioids affect post synaptic receptors?
They hyper polarise the output neurone
59
List 4 side effects fo opioids
Respiratory depression Anti-tussive (blocks cough reflex) Constipation Nausea and vomiting
60
What is the function of on cells in descending pathways?
They turn up the effect of pain

Pharmacology Y2 (9 decks)

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