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28 Cards in this Set
- Front
- Back
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emu oil is used topically to treat?
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pain associated with arthritis
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where is substance P released?
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sites of injury and the C fibers of the spinal cord
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what is the drug that leads to chronic stimulation of substance P release and ultimately to its depletion resulting in relief of pain?
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capsaicin
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what is the drug which is being tested as a treatment of neuropathy associated with HIV?
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capsaicin
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drugs with powerful relief of pain usually act on what aspect of the pain pathway?
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the sensory aspect
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what is the NT that is most often used at the synapses of high threshold (EX. A-gamma fibers) neurons?
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glutamate
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what is the mechanism of action for phencyclidine or ketamine?
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noncompetatively inhibit the flow of ions through NMDA ion channels thus preventing a postsynaptic response
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what is the receptor which is involved in the sensitization to pain following torture or other severe trauma?
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NMDA receptor
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what type of receptors can be found at every place where synpases in pain transmission occure?
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opioid receptors
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how do opioids inhibit painful sensation?
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the inhibit the release of substance P and other excitatory NT's
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what do 5-HT fibers do and where do the originate?
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The originate in the PAG and travel down the spinal cord to interneurons which contain endogenous opioids which inhibit further transmission of pain signals
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what is the function of the NE fibers from the PAG?
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they travel down the spinal cord till the reach non-opioid inhibitory neurons and alpha-2 adrenoreceptors which are located on the spinal relay neurons
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what is the mechanism of action for duloxwtine and venlafaxine?
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they block inhibition of NE and 5-HT fibers by reuptake inhibition thus promote inhibition of pain
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with antidepressants which occurs more rapidly? Decrease in chronic pain or decrease in depression
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decrease in chronic pain
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with antidepressents which requires a higher does?
Treating depression or treating chronic pain? |
treating depression, chronic pain requires 1/10 of the dose for depression
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what is the classification of these drugs? Gabapentin, phenytoin, carbamazepine, and clonazepam
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anticonvulsants
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what type of pain can anticonvulsants be used to treat?
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neuralgias
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how are anticonvulsants thought to reduce neuralgias?
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when nerves are damaged, they increase the number of Na+ channels making the more excitable. Anticonvulsants may block these Na+ channels thus mitigate the effects of an increased number of channels
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co-administration with which drug potentiates the effects of anticonvulsants on neuralgias?
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morphine
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what is the mechanism of Ziconotide?
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powerfully blocks the N-type volatage sensitive calcium channels in neurons. IMPORTANTLY systemic administration would have severe side effects, but intrathecal administration into the dorsal horn reduces neuronal transmission of pain without the severe side effects
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why is pain elicited by the release of substance P especially difficult to bear?
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it has a strong affective response (causes feeling of dread, anxiety, and suffering) mediated by the anterior cingulate
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how should severe pain be treated?
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with multiple drugs, an opioid for dulling of sensory and affective components and a NSAID for peripheral components
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what are the 3 main types of opioids?
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1. endopioids - enkephalen system
2. endorphins - beta-endorphin system 3. endogenous opioids - dynorphin system |
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what are the two types of enkephalins?
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1. MET-
2. LUE- |
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what are the compounds that have NT-like actions and are localized to interneurons and are considered endogenous opioids?
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enkephalins
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what are the enkephalinase resistant compunds which have the MET-enkephalin moiety and can act as both NT and hormone?
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Beta-endorphins
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describe how two groups of people can have different pain tolerance?
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they have differing levels of COMT leading to differing levels of endogenous opioid release
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what is the pure antagonist to endogenous opioid receptors that negates the effect of these compounds?
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naloxone
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