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8 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Pain Pathway |
Transduction - Pain is elicited from thermal, chemical or mechanical stimulus and causesrelease of ions and cytokines that sensitise and stimulate the nociceptivereceptor. Transmission- Thiscauses an electrochemical impulse to begenerated and travel through the afferent sensory nerve to the dorsal horn ofthe spinal cord. Modulation- The impulse is then modulated through the spinothalamic tract – amplified orinhibited. Projection– Signal is sent to the reitcular formation and hypothalamus from the spinalcord. Perception- finally the impulse is transmitted to the brain where it isperceived as pain. Ongoing stimulation of the nociceptive receptor leads tocentral sensitisation also known as dorsal horn wind up. |
5 steps Transduction Transmission Modulation Projection Perception |
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Outcomes of Pain |
Release of pro-inflammatory cytokines and catecholamines Altered immune function Cardiorespiratory changes Decreases oxygen tension impairs wound healing |
4 outcomes |
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Benzodiazepines: - MoA - Side effects |
- Enhance the effect of GABA (gamma-aminobutyric acid) at the GABA A receptor - Excitation, hepatic metabolism |
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Opioids: - Location of action and actions (methadone bonus) - Types of receptors - Side effects |
- Receptors in the brain (highest concentration in the thalamus which works for chronic and poorly localised pain) and spinal cord (regulate transmission of information from primary sensory pain afferents and block release of substance P) Methadone is also an NMDA antagonist - Kappa (spinal cord and peripheral), mu (CNS and peripheral) and delta (associated with mu) - respiratory, antitussive, temperature, urine retention, nausea, ileus |
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Alpha-2 Agonists: - Location of receptors and actions - Side effects |
- Alpha-2A CNS (supraspinal analgesia, sympatholytic effects, sedation), alpha-2B spinal cord and vascular epithelium (initial vasoconstriction and spinal analgesia), alpha-2C hypothermia - Bradycardia and increase in SVR (reduce cardiac output up to 50%) - Interferes with ADH action resulting in diuresis - Vomiting and associated increased intraocular pressure |
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NSAIDs: - Location of action and actions with galliprant bonus - Types of receptors - Side effects |
- Inhibition of COX in the arachidonic acid cascade which normally metabolised into prostaglandins, prostacyclin and thromboxanes - COX-1 (cerebral cortex) - COX-2 (dorsal horn of the spinal cord) (galliprant targets PGE receptor not COX) - GIT, kidney, liver, hemostatic disorders with aspirin |
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Phenothiazines - MoA - Side effects |
- Block postsynaptic neurotransmission by binding to dopamine, muscarinic/parasympathetic, histamine, and serotonergic receptors - Vasodilation and tachycardia ACP and chlorpromazine = ANTIEMETIC |
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Ketamine - MoA - Location of Receptors - Side effects |
NMDA-receptor anatagonist modulate pain at the dorsal horn Dose dependent sympathomimetic activity Increases ICP/IOP |
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