Pain and Analgesics

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Questions and Answers

What is the primary function of analgesics?

  • To eliminate the noxious stimulus
  • To intensify the sensation of pain
  • To reduce distress associated with pain (correct)
  • To induce a state of anesthesia

What type of pain is characterized by an aberration of the normal physiological pathway?

  • Chronic pain (correct)
  • Acute pain
  • Hyperalgesic pain
  • Nociceptive pain

Which type of nerve fibre is responsible for conveying sharp, well-localized pain?

  • Aβ fibres
  • Aδ fibres (correct)
  • Aα fibres
  • C fibres

What is the result of the activation of nociceptive neurons?

<p>Depolarization of peripheral nerves (D)</p> Signup and view all the answers

What is the primary difference between nociception and pain?

<p>Pain is a subjective experience, while nociception is a direct response to tissue damage (D)</p> Signup and view all the answers

What is the primary mechanism by which opioids produce analgesia?

<p>Binding to opioid receptors in the central nervous system (D)</p> Signup and view all the answers

What type of receptors are opioid receptors classified as?

<p>G-protein coupled receptors (D)</p> Signup and view all the answers

What is characterized by the requirement of increasingly higher doses of a drug to produce a given pharmacological effect?

<p>Tolerance (B)</p> Signup and view all the answers

What is the term for the withdrawal symptoms that occur when an individual stops taking an opioid drug?

<p>Physical dependence (B)</p> Signup and view all the answers

What type of pain is often resistant to conventional analgesics and is associated with neurological disease?

<p>Neuropathic pain (D)</p> Signup and view all the answers

Allodyria is a type of pain that is characterized by an intense and unpleasant sensation in response to an excessive noxious stimulus.

<p>False (B)</p> Signup and view all the answers

C fibres are myelinated nerve fibres that convey sharp, well-localized pain.

<p>False (B)</p> Signup and view all the answers

Bradykinin is a neurotransmitter that is involved in the inhibition of nociceptive neurons.

<p>False (B)</p> Signup and view all the answers

The dorsal horn is a structure in the peripheral nerve terminal where nociceptive neurons are activated.

<p>False (B)</p> Signup and view all the answers

The.rostroventral medulla is involved in descending inhibitory controls.

<p>True (A)</p> Signup and view all the answers

Enkephalins are found in the peripheral sensory neurons.

<p>False (B)</p> Signup and view all the answers

Opioid receptors are classified as Gs receptors.

<p>False (B)</p> Signup and view all the answers

Nausea and vomiting are associated with opioid use.

<p>True (A)</p> Signup and view all the answers

Neuropathic pain is typically responsive to conventional analgesics.

<p>False (B)</p> Signup and view all the answers

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Study Notes

Pain and Analgesics

  • Pain is a subjective experience, a direct response to an untoward event associated with tissue damage, and is characterized by nociception, the perception of noxious stimuli.
  • Analgesics aim to reduce the distress associated with pain, not just its antinociceptive effects.

Types of Pain

  • Acute pain: an intense and unpleasant sensation resulting from an excessive noxious stimulus.
  • Chronic pain: aberrations of the normal physiological pathway, often accompanied by:
    • Hyperalgesia: increased pain in response to a mild noxious stimulus.
    • Allodyria: pain evoked by a non-noxious stimulus.
    • Spontaneous pain: pain without an apparent stimulus.

Nociceptive Afferent Pathway

  • Pain is transmitted through impulse activity in small-diameter primary afferent fibers of peripheral nerves, which have sensory endings.
  • C fibers (unmyelinated) have polymodal nociceptive endings, conveying dull, diffuse, burning pain.
  • Aδ fibers (myelinated) convey sharp, well-localized pain.

Modulation in the Nociceptive Pathway

  • Transmission of pain to higher centers involves descending inhibitory controls, including:
    • Amygdala
    • Insular cortex
    • Hypothalamus
    • Periaqueductal grey
    • Rostroventral medulla
    • Substantia gelatinosa

Analgesic Drugs (Opioids)

  • Opioids are derived from opium, an extract from poppy juice, and contain morphine.
  • Opioid receptors include μ, δ, κ, and ORL, which are widely distributed in the brain, spinal cord, and peripheral sensory neurons.
  • Endogenous ligands for opioid receptors include endorphins.

Mechanism of Action (Opioids)

  • Opioids act on the CNS, producing:
    • Analgesia
    • Euphoria
    • Respiratory depression
    • Depression of the cough reflex
    • Nausea and vomiting
    • Pupillary constriction
    • GI tract effects
    • Other actions

Tolerance and Dependence

  • Tolerance: increased dose required to produce a given pharmacological effect, partly due to desensitization of μ receptors.
  • Physical dependence: withdrawal causes adverse physiological effects, such as irritability, aggression, shakes, and writhing.

Neuropathic Pain

  • Neuropathic pain is associated with neurological disease, unrelated to peripheral tissue injury.
  • It is often linked to conditions like stroke, multiple sclerosis, peripheral diabetic neuropathy, and shingles.
  • Pathophysiology is poorly understood, and conventional analgesics may be ineffective, making it opioid-resistant.

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