Ibuprofen, paracetemol and naproxen are all _____ analgesics.
Codeine, dihydrocodeine, fentanyl, morphine, oxycodone, tramadol are all ____ analgesics
What is nociceptive pain?
Pain caused by stimulation of nociceptive
receptors and transmitted over intact neural pathways
Nociceptive pain is caused by damage to body tissue and usually described as a sharp, aching, or throbbing pain. This kind of pain can be due to benign pathology; or by tumors or cancer cells that are growing larger and crowding other body parts near the cancer site. Nociceptive pain may also be caused by cancer spreading to the bones, muscles, or joints, or that causes the blockage of an organ or blood vessels.
What is neuropathic pain?
Pain caused by damage to
Neuropathic pain occurs when there is actual nerve damage. Nerves connect the spinal cord to the rest of the body and allow the brain to communicate with the skin, muscles and internal organs. Nutritional imbalance, alcoholism, toxins, infections or auto-immunity can all damage this pathway and cause pain. Neuropathic pain can also be caused by a cancer tumor pressing on a nerve or a group of nerves. People often describe this pain as a burning or heavy sensation, or numbness along the path of the affected nerve.
What is step 1 on the WHO ladder of analgesia?
Non-Opioid +/- Adjuvants
What is on the WHO level 2 ladder of analgesia?
What is step 3 on the WHO ladder of analgesia?
Name two weak opioid analgesic drugs
Name 3 strong opioid analgesic drugs
What is the antidote for an opioid overdose?
Increase breakthrough oromorph to 15%. He is already on Step 3. Paracetemol would not help. The other doses are too much of an increase - only increase by no more than 50% for each change.
Tramadol stimulates the release of which neurotransmitter?
N and V
What is one of the key symptoms of morphine toxicity?
How do Gabapentin and Carbamazepine act as analgesics?
These are anti-epileptic drugs. They work by reducing neuronal excitability.
Congenital insensitivity to pain is usually as a result of a mutation of which transporter?
Abnormal, unpleasant experience, but not pain in itself.
Increased pain response to noxious stimuli
Pain response to non-noxious stimuli
Pain response in the absence of any stimuli
Spontaneous shooting pains
Increased pain threshold, but also an increased pai nresponse once the threshold has been reached.
TRPV1 receptors detect what, and above which threshold?
Temperature. Depolarise above 43 degrees celsius.
What do mechanical receptor detect?
What do chemical receptor detect?
What are Aδ Fibres?
This is the rapid "fast" pain fibres. They are myelinated, with a large diameter Intended to send a sharp initial stimulus, but pain is not distiguishable.
With regards to pain and nociception, what are C fibres?
These are the slow, unlyelinated pain fibres. They allow one to distinguish between different types of pain.
Why does rubbing something that is hurt reduce the pain?
This is because of A Beta (Type 2) fibres, that transmit the sensation of proprioception, deep touch and pressure through the dorsal column - they inhibit pain signals sent through nociceptive pathways (these originate in the spinothalamic tracts but are inibited/dampened down as thy decussate into the dorsal root ganglion).
What are enkephalins?
These are endogenous opioids
What does substance p do?
This causes mast cell degranulaton - release of histamine - further inflammation!
What is trigeminal neuralgia?
This is intesneive episodic pain, usually caused by compression of the trigeminal nerve. Treated with anticonvulsants.