Pain Flashcards
pain
most common symptom that brings a patient to a doctor. function is to protect tissue by detecting, localizing, and identifying tissue-damaging processes.
acute pain
1 week or less
chronic pain
pain for at least 6 months
chronic regional pain syndrome
limb is cold, red, muscle wasting, nail changes
mechanism of endorphin activity in CNS
inhibiting GABA, thus disinhibiting dopamine. receptors in the descending pain circuit
mechanism of endorphin activity in PNS
primary afferent neurons, peripheral sensory nerve fibers, dorsal root ganglia. inhibition of substance P (pain driver) and other tachykinin release
mechanisms of release
peripheral: mediated by stress and ACTH co-release. Central: involves innervation of the hypothalamus, midbrain, and rostral medulla
what does blocking glutamate do?
since glutamate upregulates pain system, blocking it helps prevent hyperalgesia.
what type of pain are NSAIDs used for?
inflammatory.
what are safer, NSAIDs or opioids?
NSAIDs! much less side effects.
what are the function of antiepileptic drugs?
lowering a neuron’s ability to fire, by hyperpolarization or disallowing depolarization
what happens in full pain response?
significant Ca and Na influx noted, leading to acute pain since the nerves are firing
what happens in chronic pain?
system goes awry, gets stuck. leads to central sensitization and excessive pain. the system keeps firing, and pain is from Na, Ca, and now glutamate release.
what three things can you block to stop neuropathic pain?
Glu, Na channel, Ca channel
AED side effects
generally may cause sedation, psychomotor/cognitive impairment, ataxia, tremor
