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19 Cards in this Set

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Define pain.
Unpleasant SENSORY & EMOTIONAL experience arising from actual or potential tissue damage or described in terms of such damage.

Also a protective mechanism which encourages escape from a damaging stimulus
Nociceptors:

- respond to what?
- adaptability
- types x6
noxious stimuli

none

cutaneous
visceral
somatic
chemical
mechanical
thermal
Continuous stimulation of nociceptors can lead to what?
Primary hyperalgesia
Silent Nociceptors:

- response?
- activation after?
- mechanism?
Does not respond to normal noxious stimuli.

Tissue injury

Repetitive C fiber firing producing secondary hyperalgesia as a result of central sensitization.
Silent nociceptors are activated by ______ which can produce ______ as a result of _____.
repetitive C fiber firing

secondary hyperalgesia

central sensitization
A-delta fibers

- type of receptor
- character of pain
- myelination
Mechanothermal
Mechanical

Initial
Sharp
Well-localized pain

Thinly myelinated
C fibers

- type of receptor
- character of pain
- myelination
All types of nociceptors
(polymodal)

Dull
Diffuse pain

Non-myelinated
Where is the synapse site for primary pain afferents?
Laminae I and II

of

Dorsal horn
What receptors are activated by aspartate and glutamate?
NMDA receptors
Explain why rubbing your bruise after slamming your shin on a coffee table alleviates the pain. Use the gate control theory of pain to explain.
Initial pain from slamming your shin feeds in thalamus via A-delta and C afferent pain fibers which also inhibits the substantia gelotinosa fibers (pain inhibitory pathway)

Rubbing your shin will stimulate mechanoreceptor (A-beta) which stimulate the substantia gelatinosa neurons, thus blunting the pain.
Diagnosis of pain is based on what factors? x4
Background (social, cultural)

Age

Gender

Interaction with PCP
What method is useful for chronic pain?
Stairstep method
Describe level 1 of stairstep method.
Use non-opioid drugs
(NSAID or antidepressant drugs)

+/- adjuvant drugs
Describe level 2 of stairstep method.
Low potency opioid drugs
(codeine)

+/- adjuvant drugs
+/- non-opioid
Describe level 3 of stairstep method.
Full agonist, high potency opioid drugs
(morphine)

+/- adjuvant drugs
+/- non-opioid
Adjuvant drugs used to treat pain. x6
1. Antihistamine
2. Amphetamines
3. Benzodiazepines
4. Beta-adrenergic antagonists
5. Cytokine antagonists
6. Steroids
What type of therapy would be used with migraines?
Preventative therapy

Abortive therapy
What type of drugs would you use for neuropathic pains? x4
Antidepressants
Anticonvulsants
Oral local anesthetic
Topical local anesthetic
What drugs would you use with a Sickle cell crisis? x3
Morphine
Meperidine
NSAIDS