Pain and Pharmacology

Question 1

what are the 6 classifications of pain

Answer 1

Acute, Chronic, Relapsing, Somatic, visceral, neuropathic

Question 2

what is somatic pain?

Answer 2

sharp, localised fast pain usually results from outside (delta fibres)

Question 3

what is visceral pain?

Answer 3

dull and not localised, slower pain that comes from internal (c-fibres)

Question 4

how to assess pain (acronym)

Answer 4

Onset
Location 
Duration 
Character
Aggravating factors 
Relieving factors 
Timing 
Severity

Question 5

Indications of Entonox (3)

Answer 5

combination use
labour
to gain IV access

Question 6

Contraindications of Entonox (6)

Answer 6

Diving in 24 hrs 
head injury 
reduced GCS 
psychotic episode 
eye surgery 
bowel obstruction

Question 7

cautions of enotnox (3)

Answer 7

abdo pain
alcohol
drugs

Question 8

how does entonox work?

Answer 8

causes release of internal opioids and sends impose down defending pain pathway. Agonist at GABA receptors

Question 9

indications for paracetamol (3)

Answer 9

mild to moderate pain
combine with other analgesia
antipyretic

Question 10

paracodynxmics of paracetamol

Answer 10

inhibits prostaglandins synthesis by inhibiting COX pathways. acts on descending pain pathway

Question 11

indications of Morphine (2)

Answer 11

cardiac pain

moderate to serve pain

Question 12

contraindications of Morphine (5)

Answer 12

respiratory depression 
hypotension 
LOC 
head injury 
children under 1

Question 13

cautions of morphine (5)

Answer 13

pregnancy 
chest injuries 
intoxication 
renal impairment 
small head injury

Question 14

pharmacodynamics of morphine

Answer 14

CNS agonist

Question 15

Pharmcodynamics of Diazepam

Answer 15

CNS depressant, stimulates GABA (an inhibitory neurotransmitter)

Question 16

Indications for Diazepam? (3)

Answer 16

Convulsions lasting longer than 5 mins 
Repeated convulsions (3 or more in 1 hr) 
symptomatic cocaine toxicity

Question 17

contraindications for Diazepam (1)

Answer 17

known sensitivity

Question 18

Cautions for Diazepam (2)

Answer 18

alcohol

if dose has been given by carers

Question 19

mechanism of action for midazolam

Answer 19

GABA stimulant which depresses the CNS

Question 20

indications for midazolam (1)

Answer 20

First intervention for long or repeated convulsions

Question 21

indications for glucagon (1)

Answer 21

hypoglycaemia

Question 22

cautions for glucagon (2)

Answer 22

starvation

seizures

Question 23

contraindications for glucagon (2)

Answer 23

adrenal tumor

IV

Question 24

Pharcodynamics of glucagon

Answer 24

raises blood sugar by activation of hepatic glucagon receptors, stimulation glycogenolysis and release of glucose

Question 25

indications for glucose IV (3)

Answer 25

hypoglycaemia (less then 4)
unconscious pt
did not respond to IM glucagon

Question 26

cautions for glucose IV (1)

Answer 26

flush well after administration to avoid vein irritation

Question 27

pharmcodymanics of glucose

Answer 27

direct delivery go glucose to the body so the body does not need to produce it. enters the normal cycle and converted into energy (glycolysis)

Question 28

indications for ondansetron (2)

Answer 28

opiate induced nausea

nausea or vomiting

Question 29

cautions for ondansetron (4)

Answer 29

Long QT
hepatic impairment
pregnancy
breast feeding

Question 30

contraindications for ondansetron (2)

Answer 30

children under 1 month

known sensitivity

Question 31

pharmacodynamics of ondansetron

Answer 31

selective serotonin 5HT receptor antagonist.