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30 Cards in this Set
- Front
- Back
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What is chronic pain?
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On going tissue injury that may be caused by persistent activation of these fibres. Persists long after trauma has healed |
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What is acute pain?
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Occurs in response to tissue injury and results from the activation of peripheral pain receptors.
warns of potential damage that requires action of the brain. |
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What is nociceptive pain?
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caused by stimulation of peripheral nerve fibres that respond only to stimuli approaching or exceeding harmful intensity.
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What are somatic pain receptors?
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They are located in the skin, subcutaneous tissues and other connective tissues. Usually produce sharp or dull localised pain.
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What are visceral pain receptors?
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They are located in the most viscera and the surrounding connective tissue.
visceral pain due due to obstruction of a hollow organ= poorly localised, deep and cramping. |
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What is neuropathic pain?
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Caused by damage or disease affecting any part of the nervous system involved in bodily feelings (somatosensory system)
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How is peripheral neuropathic pain described?
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Described as burning, tingling, stabbing, "pins and needles" and electrical
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What is the visceral pain pathway
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pain fibres enter the spinal cord at the dorsal root ganglia and synapse in the dorsal horn.
From there, fibres cross the other side and travel up the lateral columns to the thalamus and then to the cerebral cortex. |
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Explain the term "pain mediators" and give examples
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Substances released when tissue is injured.
substance P, Calcitonin gene-related protein (CGRP) and Neurokinin A. |
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What is cancer/malignant pain?
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Tumours can invade healthy tissues and place pressure on blood vessels and nerves producing pain.
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COX 1 responsible for..
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Physiological stimuli
protective prostaglandins- stomach mucosa and platelet stickiness |
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COX 2 responsible for..
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Infection, injury
Inflammatory prostaglandins- fever, pain. |
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NSAIDS act..
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on substances in the body that can cause inflammation and pain.
E.g. Aspirin acts on cyclooxygenase |
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How are corticosteroids administered?
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At the site of musculoskeletal injuries. They exert powerful anti-inflammatory effects.
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How does acetaminophen work?
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The increase the body's pain threshold, but has little effect on inflammation
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What are muscle relaxants?
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They reduce pain by sedative action in the CNS. Reduce pain from tense muscle groups.
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How do anti-depressants work?
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particularly with tricyclics- reduce pain transmission through the spinal cord.
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What do anticonvulsant drugs do?
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relieve pain of neuropathies, possibly by stabilising nerve cells.
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What are the side effects of NSAIDs?
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Gastric bleeding due to NSAIDs
Inhibition of COX2 which occurs with both non selective COX inhibitors= prothrombic effect that can increase the risk of MI, Stroke and claudication |
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What similarities to NSAIDs and non NSAIDs share in terms of how it affects body functions?
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Impairs renal function
Can cause Na+ and water retention |
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What do opioids do?
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promote analgesia by acting on receptors located on neuronal cell membranes.
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What major effect on the CNS do opioids have?
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They inhibit neurotransmitter release
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What are the 3 major type of Opioids?
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Mu, delta and Kappa
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How does the half life of opioids differ between adults and the elderly?
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Opioids have a larger half life and a greater analgesic in the elderly.
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What can occur at any age when you take opioids? (Adverse effects)
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Constipation and urinary retention
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Opioids should be used cautiously in patients with certain disorders such as...
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Patients with hepatic disorders because drug metabolism is delayed.
COPD because respiratory depression is a risk Some neurologic disorders such as dementia and encephalopathy because delirium is a risk. Severe renal insufficiency because metabolites may cause problems |
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How is pain expressed on the face?
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Through the trigeminal nerve.
Somatosensory neurons travel to the CNS through the trigeminal nerve. They synapse in the trigeminal nucleus in the mod-medulla and also neurons on the lower medulla. These neurons then send signals throught the trigeminal- thalamic tract w/in he midbrain to the thalamus. Neurons in the thalamus relay signals to the somatosensory cortex and limbic system. |
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What are the main drugs used to treat pain?
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Non opioids and opioids
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What are the main drugs used to treat neuropathic pain
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anticonvulsants, antidepressants and other CNS-active drugs.
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What are further adverse effects of opioids
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opioid naive patients: vomiting, nausea, itching.respiratory depression is serious but rare when given at appropriate doses.
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