Contorl Of Pain & Inflammation

Front 1

Acute Pain Experience

Back 1

1. Peripheral tissue injury (surgical/trauma)
2. Release of tissue humoral mediators
- cells release K+, bradykinin, histamine and cytokines
-phospholipase A2 activates arachodonic acid
-cyclooxygenases produce prostaglandins that induce inflammation and stimulate nocireceptor
3.afferent neural transmission
-afferent impuls transmitted along A delta an C fibres synapse at the substantia gelatinosa f the dorsal horn of the spinal cord
4. spinal cord receptors (substansia gelatinosa)
-substantia gelatinosa (SG) is stimulated by substance P released by afferent neurons
-transmits signal via spino-thalamic tract to cerebral cortex

Front 2

Acute Pain Experience (LAST STEP)

Back 2

5. reflex sympathetic response to the painful stimulus
-reflex arc leads to sympathetic efferent activity to injured are
-blood flow reduced, muscle hypertonicity (increase pre. or tone) occurs

OR

Transmission to the Brain (spinothalamic tract)
-descending PW from the cerebral cortex release endogenous opiods, GABA, 5-HT and NE inhibiting the release of substance P from different neurons in the substantia gelatinosa

Front 3

Non-steroidal anti-inflammatory drugs (NSAIDs)

Back 3

MECH: inhibits COX1 +2
Effects: reduce inflammation, fecer, pain
A.E: PUD

Front 4

GABA-Receptor Agents

Back 4

MECH: bind to GABA receptor and intensify GABA effect ( endogenous pain suppression PW)

Front 5

Serotonin Agonists

Back 5

MECH: release 5-HT
Triptans: effective in tx of headache (vasoconstrictive effect)
TCA increase amt of seratonin

Front 6

Opioids

Back 6

MECH: stimulate mu and kappa opioid receptors in the brain
EFFECTS: mod-severe+visceral pain
WITHDRAWL: Rhinorrhea, lacrimation, chills, gooseflesh, muscle aches, diarrhea, anxiety, hostility

Front 7

Non-opioid Analgesics

Back 7

ref to NSAIDs

include acetaminophenn, NSAIDS, and some centrally acting agents (ie. caffeine)

Front 8

Glucocorticoid

Back 8

MECH: -inhibit release of histamines
-block PLP A2 + COX2
-inhibit immune response (PAF, phags, ILs)

EFFECT: reduces inflammation

A.E: -adrenal insufficiency, hyperglycemia, mood changes, osteoporosis, immunosuppression

Front 9

Antipyretics

Back 9

*acetaminophen is first choice for all pop*
MECH: -inhibit signalling for increased temp
EFFECT: decrease temp
A.E:
Reye’s: brain swelling, fatty liver deposits, die in days
-->previous viral illness + ASA

Front 10

Antihistamines

Back 10

MECH: blocks H1 receptor (antagonist)
EFFECTS: symptomatic relief of runny nose, sneezing, itchy eyes
*effective in tx of motion sickness*
A.E: benadryl--> mania in kids

Front 11

Anaphylaxis

Back 11

Adrenergics: EN- stimulates alpha 1(increases BP), beta2 (induces bronchodilation) and beta 1 receptors (increases CO)
antihistamines
beta2 adrenergic agonists
systemic glucocorticoids: inhibit immune and inflammatory response to antigen

Front 12

alpha 1 stimulation

Back 12

increase in BP

Front 13

beta 1 stimulation

Back 13

increased CO

Front 14

beta 2 stimulation

Back 14

bronchodilation