Week 230 - Pain Flashcards Preview

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Flashcards in Week 230 - Pain Deck (33):
1

Week 230

 

Ibuprofen, paracetemol and naproxen are all _____ analgesics.

Non-opioid

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Week 230

 

Codeine, dihydrocodeine, fentanyl, morphine, oxycodone, tramadol are all ____ analgesics

Opiod

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Week 230

 

What is nociceptive pain?


Pain caused by stimulation of nociceptive
receptors and transmitted over intact neural pathways

 

AKA

 

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.

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5

Week 230

 

What is neuropathic pain?


Pain caused by damage to
neural structures
 

AKA

 

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.

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Week 230

 

What is step 1 on the WHO ladder of analgesia?

Non-Opioid +/- Adjuvants

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Week 230

 

What is on the WHO level 2 ladder of analgesia?

Weak opioid

+ non-opioid

+/- adjuvants

8

Week 230

 

What is step 3 on the WHO ladder of analgesia?

Strong Opioid

+ Non-opioid

+/- adjuvants

9

Week 230

 

Name two weak opioid analgesic drugs

Codeine

Dihydrocodeine

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week 230

 

Name 3 strong opioid analgesic drugs

Fentanyl

morphine

oxycodone

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Week 230

 

What is the antidote for an opioid overdose?

Naloxone

12

Week 230

 

 

Q image thumb

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.

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Week 230

 

Tramadol stimulates the release of which neurotransmitter?

Serotonin

14

Week 230

 

 

Q image thumb

N and V

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Week 230

 

What is one of the key symptoms of morphine toxicity?

Hypotension

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Week 230

 

How do Gabapentin and Carbamazepine act as analgesics?

These are anti-epileptic drugs. They work by reducing neuronal excitability.

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Week 230

 

Congenital insensitivity to pain is usually as a result of a mutation of which transporter?

Na+

18

Week 230

 

Define: Dysasthesia

Abnormal, unpleasant experience, but not pain in itself.

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Week 230

 

Define: Hyperalgesia

Increased pain response to noxious stimuli

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Week 230

 

Define: Allodynia

Pain response to non-noxious stimuli

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Week 230

 

Define: Paraesthesia

Pain response in the absence of any stimuli

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Week 230

 

Define: Paroxysms

Spontaneous shooting pains

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Week 230

 

DEfine: Hyperpathia

Increased pain threshold, but also an increased pai nresponse once the threshold has been reached.

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Week 230

 

TRPV1 receptors detect what, and above which threshold?

Temperature. Depolarise above 43 degrees celsius.

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Week 230

 

What do mechanical receptor detect?

Stretch

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Week 230

 

What do chemical receptor detect?

Inflammation

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Week 230

 

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.

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Week 230

 

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.

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Week 230

 

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).

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Week 230

 

What are enkephalins?

These are endogenous opioids

31

Week 230

 

What does substance p do?

This causes mast cell degranulaton - release of histamine - further inflammation!

32

Week 230

 

What is trigeminal neuralgia?

This is intesneive episodic pain, usually caused by compression of the trigeminal nerve. Treated with anticonvulsants.

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