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22 Cards in this Set
- Front
- Back
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What are pain management techniques?
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-stabilization
-reduction in stress -muscle relaxation -ice packing -acupuncture -drugs -consider degree and type of pain -consider best route -consider individual patient problems -consider owner compliance -always think multi modal |
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What are analgesic drugs?
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-opiods
-alpha-2-agonists -NSAIDS -Tramadol -NMDA receptor antagonnnists -Na channel antagonists -topical agents -antidepressants -anticonvulsants |
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What is chondroprotectants-cosequin and Dasuquin?
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the protect cartilage
-glucosamine -low molecular weight sodium chondrotin sulfate -glycosaminoglycans (dasuquin) |
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What is Adequan?
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polysulfate glycosaminoglycans
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What are biphosphates?
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pamidronate
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What are opiods?
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main stay of perioperative analgesia
milk to severe pain depending on particular drug mostly used injection receptors are pre and post synaptic in the CNS |
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What is the mechanism of action for opioids?
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effects on system excitability
-membrane hyperpolarized and inhibition of opening of voltage senestive Ca++ channels -depresses release of NT from terminal |
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What is transdermal fentanyl?
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slow onset-time and applied 12-24 hours before needed
provides long duration analgesia potential for abuse and really expensive |
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What is the duration of analgesia for epidural morphine?
Side effects? |
10-24 hours
pruritus urinary retention |
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What is an example of peripheral opioids?
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intrarticular morphine
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What are alpha 2 agonists?
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xylazine, demedetomidine and romifidine
effective analgesic and synergistic with opiods mild to moderate pain effectiveness can cause profound cardiovascular effects (CRI) can be injectable and epideral have pre and post synaptic receptors in the spine and decrease neuronal excitability |
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What are the effects of inflammatory mediators?
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they lower the threshold of peripheral terminal of pain fibers or initiate action potentials
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What is tramadol?
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a drug whose mode of action isn't well understood
considered opioid like and binds weakly to u receptors and inhibits reuptake of norepi and serotonin not reverse by naloxone minimal side effects and drug interactions good bioavailability in cats caution in animals with seizures (lowers seizure threshold) |
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What are sodim channel antagonists?
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local anesthetics
central and peripheral sodium channels blockade of sodium channel prevents upstroke of axonal action potential nerve blocks systemic lidocaine |
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What are NMDA receptor antagonists?
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antagonize NMDA receptors in the spinal cord
nmda receptors are inactive in normal animals and activated by injury implicated in development of central sensitization wind-up treat with ketamine injectable amantadine oralm methadone and meperidine tramadol (needs to be given ever 6-8 hours) |
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What are examples of topical analgesics?
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lidocaine patch for painful points, bone tumors and fractured limbs
EMLA- catheter palcement and epidurals NSAID patches and gels not available in the US (dichlofenic patch in horses with osteoarthritis) |
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What are the effects of antidepressants on pain?
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can be used in chronic pain syndromes
amitryptiline, fluoxetine (prozac) watch for serotonin syndrome if mixing drugs with these effects |
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What are examples of anticonvulsants that provide relief for mild to moderate pain?
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gabapentin no GAG action (Ca modulation in dorsal horn)
pregbalin typically for neuropathic pain of cancer related pain difficult to definitely diagnose in vet med recently used for other types of pain |
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What are examples of acute pain?
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-surgical pain
-tissue damage from trauma - can pre-emptive analgesia to reduce likelihood of central sensitization |
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How do we treat post operative pain?
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injectable analgesics can be used in immediate post-operative period
consider continuing CRI nothing wrong with intermittent injections stabilization ice packing |
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What is chronic pain?
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pain that lasts longer than 2-6 months after initial insults/trauma
osteoarthritis, chrinic pain, neuropathic pain - need analgesics at home |
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How to you manage osteoarthritis?
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weight control
common pain managment fish oil gabapentin and amantadine |
