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33 Cards in this Set
- Front
- Back
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first pain
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fast travelling: A delta fiber
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second pain
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slow travelling
c fibers |
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types of neuropathic pain
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deafferentation pain
sympathetically maintained pain |
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what is the cauise of the phentom pain
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deafferentation pain: Due to partia;l or compm,ete interruption of peripheral or central afferent neural activity.
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peripheral neuropathy with antiretrovirals
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didanosine
stavudine zalcitabine |
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trigeminal neuralgia
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treatment:
caramazepine Alternatives: amitryptiline phenytoin gabapentin |
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does not bind to gaba receptors: but is an analog of it:
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gabapentin:
antiepileptic drug 100%oral bioavailability |
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effective in different types of neuropathic pain:
even after NSAIDS, opiods, amitryptiline carbamezepine have failed |
gabapentin
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anticonvulsants used in neuropathic pain
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gabapentin
lamotrigene phenytoin |
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antiarrhythmics used in neuropathic pain
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lidocaine
mexilitene |
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antidepresssents used in anagestic"
inhibit reuptake of NE or serotonin. |
amitriptyline
nortriptyline fluoxetine paroxetine duloxetine: for diabetic neuropathy |
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specific precautions:
with SSRIs |
ritonavir
tramadol suicidal risk. |
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opoid agents
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act at spinal and supraspinal opiod receptors, used in both nociceptive and neuropathic pain
EX: morphine hydromorphone fentanyl codeine |
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NSAIDS
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used more for nociceptive pain
ex: aspirin ibuprofen celecoxib |
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glucocorticoids
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used more for:
neuritis edematous nerve compression syndrome edema |
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sensitization of nocicepptors
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prostaglandins;from damaged cells
leukotrienes: FRom damaged cells substance p: from primary afferents |
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opoids used in
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analgesia
anethesi ACUTE PUlmonary edema cough diarrhea |
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opoids selected agonists:
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morphine
meperidine fentanyl methadone heroin codeine oxycodone hydrocodone |
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opioids partial agonists
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tramadol
nalbuphine buprenorphine: for severe pain treatment. |
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opioids antagonists
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naloxone
naltrexone: long acting: 48 hrs alvimopan: peripheral opoid receptors: revereses the effect of opioid effcet of contipation in GI. |
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many cough medicines have it and are antitussive: but act at opioid receptors.
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dextrometorphane
levopropoxyphene |
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natidiarrheals that work on opioid receptors:
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loperamide
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Apomorphine
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derivative of morphine but does not bind to opioid receptors
centrally acting dopa,inergic drug used for parkinson't disease powerful emetic drug in the treatment of addiction |
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lowest risk of GI bleeding wirh NSAIDs
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acetaminophen
ibuprofen |
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high risk of GI bleed with NSAIDs
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piroxicam: long half life accumilate in body
indomethacin ketoprofen |
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one of th etransient effecet of opiods seen
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pruritis, euphoria, dysphoria, confusion, respiratory depression
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mechanism of respiratory depression on opiods
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direct depression of respiratory centerss in CNS
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opiod induced incresased smooth muscle tone
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mainly mu
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opiod induced decreased secretion adn increased absorption
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mu, delta, kappa
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spinal cord action of opioids
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delta
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brain action of opiods
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mu, delta
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opiod induced vommiting
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direst effect on chemoreceptor triggered zone in area prostema
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opiod induced urinary retension
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relaxation of detrusor muscle
constriction of sphincter vesicae So give carbachol and betanechol. |
