Week 6: Pain management Flashcards
medication for nociceptive pain
NSAID / opioids
medicine for neuropathtic pain
antidepressant
anticonvulsants
topical agents
Adjuvant pain medications
not typically used for pain but may be helpful for its management;
NSAIDS
block a specific enzyme cyclooxygenase (or COX) used by the body to make prostaglandins.
opioids
Act as agonists at receptor sites in the brain,
spinal cord and other sites outside of the CNS
Tramadol
weak mu opioid receptor agonist Enhances noradrenergic and serotonergic
inhibition
morphine
activation of the opioid receptor in the neuron release of GABA which cause neighbouring cell to release dopamine and binds to nociceptor
Ketamine
NMDA antagonist
Cannabinoids
bind with the endocannabinoid
receptors, suppress signals such as pain, nausea and
depression, boost signals of appetite and euphoria.
Anticonvulsants
Modulates neurotransmitter release by binding to voltage
gated Ca++ channels
Closes pre-synaptic Ca++ channels
Diminishes excessive neuronal activity and neurotransmitter
release
Used for neuropathic pain,
Antidepressants
Central blockade of serotonin and noradrenaline reuptake
process.
MORNRI tapentadol
mu opioid receptor agonist and noradrenaline re uptake inhibitor
WHO: analgesic ladder
non opioids= paracetamol
weak opioids= NSAID/ oral opioids
strong opioids and non opioids = increase oral opioid/ iv/sc opioid/ In fentanyl
classify CAM
Whole medical systems:
– e.g. Traditional Chinese Medicine
* Mind‐body medicine:
– e.g. meditation
* Biologically based practices:
– e.g. herbs, vitamins
* Manipulative and body‐based practices:
– e.g. chiropractic, massage
CBT
psychological technique that can be taught to
patients to reframe thoughts and change the pattern of
thinking:
* Identify negative thoughts and then change them
