Pharmacological controll of pain 4.0 / 5 based on 1 rating ? BiologypharmacyUniversityNone Created by: Annabel ForsdykeCreated on: 23-04-15 13:38 Non-opioid analgesics for inflammatory, rheumatoid and myalgic pain NSAIDS, paracetamol, nefopam, steroids. 1 of 29 When would you use nefopam? For pain that is unresponsive to opioids and NSAIDs 2 of 29 Non-opioid analgesics for neuropathic pain anti-convulsants (Na channel blockers), anti-depressant agents (amino uptake inhibitors) and calcium channel blockers. 3 of 29 Non-opioid analgesics for migraine 5-HT agonists, miscellaneous agents 4 of 29 What is an important lipid produced from membranes, what enzyme Arachadonic acid, phospholipase A2 5 of 29 What happens to arachadonic acid? Cyclo-oxygenase 1 breaks it down into cyclic endoperoxides PGG2, which is converted into PGH2 6 of 29 What is PGH2 converted into? Enzymes? PGE2 > isomerase. PGI2 > prostacyclin synthase 7 of 29 Do PGE2 and PGI2 cause pain? No- they sensitise tissues to other stimuli that are painful. Enhancers rather than producers. 8 of 29 Why is there a local increase in prosoglandin production? More phospholipase A2 and cyclo-oxygenase 2 upregulated by cytokines, growth factors, endotoxins. 9 of 29 What do prostoglandins do? acts directly to increase activity of sensory neuron specific VGnaC. Reduces activity of vgK channels. Much more likely to fire. 10 of 29 another action of prosoglandins Sensitise vaniloid polymodal receptors - trpv1. 11 of 29 How do NSAID's work? Block the cyclooxygneases, make the neurons less 'twitchy' 12 of 29 What are prostaglandin receptors? DP, EP, FP IP, TP. GPCRs linked to adenylate cyclase 13 of 29 CNS effect of NSAIDs anti-pyretic, reduce temperature because they inhibit the release of prostoglandins in the hypothalamus 14 of 29 All NSAIDs have the same side effects, what are they? - Dyspepsia, nausea, skin reactions, renal insufficience, nephropaty, bronchospasm. 15 of 29 How does asprin work? Acetylates the enzyme and permanantly disables it. 16 of 29 When asprin acetylates COX enzymes, what happens it can'tmake prostaglandins, it makes lipids called lipoxins that resolve inflammation 17 of 29 Why can't children have asprin? Can give rise to reyes syndrome. 18 of 29 Iboprufens mechanism of action reversible blocker of COX1 and Cox2, cox1 more. 19 of 29 Why can't we target cox2? Role in the protection against thrombosis, so leads to heart attacks. 20 of 29 Other NSAID approachesS NO-NSAIDS, LOX COX inhibitors. 21 of 29 Suggested mechanism for paracetamol action? Activate TRPA1 receptors, or COX3 sliced variant of COX1 22 of 29 Examples of neuropathic pain trigeminal neuralgia, post-herpatic neuralgia - after shingles. diabetic neuropathy. reflex sympathetic dytrophy (bullet). 23 of 29 The drug of choice in trigemnial neuralgia and it's mechanism carbamezapine, an anti-convulsant sodium channel blocker. 24 of 29 Unwanted side effects of carbamazepine sedation, ataxia, blurred vision, leucopenia 25 of 29 Drug to treat post-herpetic neuralgia and reflect sympathetic dystropy amytriptyline, a tri-cyclic antidepressants that prevents amine uptake 26 of 29 How do VGnaC work without killing us. they are state dependant. blocks past a certain frequency of firing. 27 of 29 Gabapentin Ca2+ channel blocker, binds to a2delta subunit. neurotonin anticonvulsant. 28 of 29 PregbaLIN A new improved version of gabapentin 29 of 29
Comments
No comments have yet been made