Pain and analgesia Flashcards Preview

Principles of Science BVetMed 3 > Pain and analgesia > Flashcards

Flashcards in Pain and analgesia Deck (47)
Loading flashcards...
1

Define pain

an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

2

What is adaptive pain (protective)?

- protective pain
- nociceptive pain
- inflammatory pain

3

What is maladaptive (pathological) pain?

- serve no protective function
- neuropathic pain (abnormal)

4

Define acute pain

often has an obvious cause and is relatively short duration (hours to days)

5

Define chronic pain

pain lasting longer than 1 month, associated with a wide range of often subtle behavioural disturbances

6

Outline the 3 processes of pain

1. NOCICEPTION: sensory process by which a noxious stimulus is transmitted to the brain (transduction, transmission, modulation)
2. PERCEPTION of an unpleasant sensation in CNS
3. BEHAVIOURAL response to pain -varies according to species

7

Define allodynia

painful response to a normally innocuous stimulus

8

Define hyperalgesia

increased response to painful stimulus

9

What does hypersensitisation mean?

- level of pain perceived is more severe
- analgesic drugs may be less effective if given once pain is present
- one type of analgesic may not be effective on its own

10

What causes variations in behaviour to pain?

- species (prey vs. predator)
- breed (labrador vs greyhound)
- demeanour

11

How can pain be assessed?

- scales: visual analogue or numerical rating
- simple descriptive: no pain to worst pain imaginable
- composite scoring system (based on different behaviours)
- multidimensional scoring system

12

What pain scoring systems are validated in horses? 4

- composite orthopaedic pain
- equine acute abdominal pain scale (EAAPS)
- complex numerical rating scale - postop colic
- post abdominal surgery pain assessment scale (PASPAS)

13

Ideal features of pain assessment in practice

- simple
- repeatable and reproducible
- minimal time
- allows effective pain management

14

Multimodal analgesic options

- opioids
- NSAIDs
- ketamine
- alpha-2-agonists
- local anaesthetics

15

What receptor does ketamine antagonise?

NMDA-R

16

Describe multi-modal analgesia

- attack pain pathway at multiple sites
- each method helps in overall control of individual pain
- more effective than using single method of analgesia
- allows lower doses of each drug to be used, reducing the risk of side effects

17

Use - gabapentin

usually for chronic pain

18

List systemic analgesia options

- opioids
- NSAIDs
- ketamine
- lidocaine
- alpha 2 agonists
- (tramdol)
- (gabapentin/ pregabalin)
* (chronic pain)

19

List local analgesia options

- local anaesthetics
- opioids
- alpha 2 agonists

20

Define opium

mixture of alkaloids from poppy plant

21

Define opioid

any naturally occurring, semi-synthetic or synthetic compound that binds to opioid receptors and shares the proerties of the natural occuring endogenous opioids

22

Define opiate

any naturally occuring opioid, derived from opium (e.g. morphine, codeine)

23

Define narcotic

from the Greek meaning 'to numb'. It was used to denote an opioid but also to describe non-opioid drugs of addiction

24

Name 2 naturally occurring opioids

- morphine
- codeine

25

Name 4 semi-synthetic opioids

- diamorphine (heroid)
- dihydromorphone
- buprenorphine
- hydromorphone

26

Name 7 synthetic opioid compounds

- pethidine
- methadone
- fentanyl, alfentanil, remifentanil
- butorphanol, tramadol

27

What are the 4 receptors opioids mediate their effects through?

- delta
- kappa
- miu
- (nociceptin)
* kappa and miu are the most important, miu provides most analgesic effects but also some side effects

28

List some full miu agonist (opioids)

- morphine
- methadone
- pethidine (licensed)
- fentanyl / remifentanil
- etorphine (Immobilon)
- Papaveretum (Omnopon)

29

Example of a partil miu agonist

Buprenorphone (licensed)

30

Example - mixed opioid agonist-antagonist

Butorphanol (licensed)

Decks in Principles of Science BVetMed 3 Class (110):