PCOL 7-2 Chronic Pain
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Questions and Answers

Which of the following best defines chronic pain?

  • Pain that is only physical in nature
  • Pain that is caused by inflammation
  • Pain that lasts less than 3 months
  • Pain that persists beyond wound healing (correct)

    • Which of the following can cause neuropathic pain?

  • Arthritis
  • Lack of exercise
  • Peripheral nerve injury (correct)
  • Normal aging process

    • What is hyperalgesia?

  • Pain that is only physical in nature
  • Pain that is caused by inflammation
  • Reduced pain response threshold (correct)
  • Spontaneous pain

    • Which of the following methods is used to induce inflammatory pain in animal models?

    <p>Injection of carrageenan</p> Signup and view all the answers

    What is the purpose of using von Frey filaments in measuring responses to pain?

    <p>To assess mechanical allodynia</p> Signup and view all the answers

    Which of the following is NOT a potential effect of chronic opioid use?

    <p>Increased analgesia</p> Signup and view all the answers

    What happens to surviving primary afferents in cases of partial damage?

    <p>They sprout into pain pathways</p> Signup and view all the answers

    Which of the following is a characteristic of opioids in treating chronic pain?

    <p>They have little/no effect on non-noxious afferents</p> Signup and view all the answers

    Which type of VGCC is found in the central presynaptic terminals of afferents entering the spinal cord?

    <p>N-type VGCC</p> Signup and view all the answers

    Which type of VGCC blocker is derived from cone-snail toxins?

    <p>N-type blockers</p> Signup and view all the answers

    What is the mechanism of action of GABA analogues in treating neuropathic pain?

    <p>They reduce NT release by binding to VGCCs</p> Signup and view all the answers

    What is the current 'best practice' approach to treating neuropathic pain?

    <p>GABA analogues</p> Signup and view all the answers

    What are some side effects of GABA analogues in treating neuropathic pain?

    <p>Dizziness, sedation, memory loss</p> Signup and view all the answers

    Which class of antidepressants includes amitriptyline and nortriptyline?

    <p>TCA's</p> Signup and view all the answers

    Which neurotransmitters do antidepressants primarily target?

    <p>Norepinephrine and serotonin</p> Signup and view all the answers

    Which receptors do some antidepressants have mixed actions at?

    <p>5-HT2, H1, H2, mAChR</p> Signup and view all the answers

    Which neurotransmitter is involved in the mood modulation of pain pathways?

    <p>Serotonin</p> Signup and view all the answers

    What is the mechanism of action of topical TRPV1 agonists like capsaicin?

    <p>Depletion of nociceptors</p> Signup and view all the answers

    What is the function of TRPV1 receptors in the body?

    <p>Sensing painful heat</p> Signup and view all the answers

    Which of the following is NOT a first-line treatment for neuropathic pain?

    <p>Ziconotide</p> Signup and view all the answers

    What is the main mechanism of action of gabapentin and pregabalin in treating neuropathic pain?

    <p>Enhancement of GABA activity</p> Signup and view all the answers

    Which type of chronic pain can be treated with topical capsaicin?

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

    Which class of drugs is considered a second-line treatment for neuropathic pain?

    <p>Opioids</p> Signup and view all the answers

    Study Notes

    Chronic Pain and Neuropathic Pain

    • Chronic pain is defined as persistent pain lasting more than three months, affecting daily activities and quality of life.
    • Neuropathic pain can be caused by conditions such as diabetes, nerve injury, or infections affecting the nervous system.

    Hyperalgesia

    • Hyperalgesia refers to an increased sensitivity to pain, resulting in exaggerated responses to noxious stimuli.

    Induction of Inflammatory Pain

    • Inflammatory pain in animal models is typically induced using agents such as complete Freund's adjuvant or carrageenan.

    Measuring Pain Responses

    • Von Frey filaments measure mechanical thresholds to evaluate nociceptive (pain-related) responses in animal models.

    Opioid Use Effects

    • Potential effects of chronic opioid use NOT seen include enhancing immune function.

    Primary Afferents After Damage

    • Surviving primary afferents following partial damage may exhibit increased excitability and sensitivity.

    Opioids in Chronic Pain Management

    • Opioids are characterized by their ability to produce pain relief but may lead to tolerance and dependence.

    Voltage-Gated Calcium Channels (VGCC)

    • N-type VGCCs are predominantly found in the central presynaptic terminals of afferents entering the spinal cord.

    VGCC Blockers

    • Blockers derived from cone-snail toxins are classified as selective for N-type VGCCs, demonstrating potential for pain management.

    GABA Analogues in Neuropathic Pain

    • GABA analogues, such as gabapentin and pregabalin, work by inhibiting excitatory neurotransmitter release, thereby modulating pain pathways.

    Best Practice for Neuropathic Pain

    • Current best practice approaches include a combination of pharmacotherapy, physical therapy, and psychological support tailored to individual needs.

    Side Effects of GABA Analogues

    • Common side effects of GABA analogues may include dizziness, sedation, and weight gain.

    Antidepressants and Pain Management

    • Tricyclic antidepressants, including amitriptyline and nortriptyline, are often used to manage chronic pain and neuropathic pain effectively.

    Targeted Neurotransmitters

    • Antidepressants primarily target neurotransmitters such as serotonin and norepinephrine to enhance mood and alleviate pain.

    Mixed Receptors in Antidepressants

    • Some antidepressants exhibit mixed actions at receptors such as serotonin (5-HT) and norepinephrine transporters.

    Mood and Pain Connection

    • Serotonin is a key neurotransmitter involved in mood modulation, which can influence pain perception.

    Capsaicin Mechanism

    • Topical TRPV1 agonists like capsaicin act by desensitizing nociceptive neurons, ultimately reducing pain transmission.

    Function of TRPV1 Receptors

    • TRPV1 receptors are involved in sensing pain and temperature changes, playing a vital role in nociception.

    First-Line Treatment for Neuropathic Pain

    • Treatments not classified as first-line options typically include opioids and complex analgesics, replaced by safer alternatives.

    Gabapentin and Pregabalin Mechanism

    • Gabapentin and pregabalin primarily act by inhibiting the release of excitatory neurotransmitters through the modulation of VGCCs.

    Chronic Pain Treated with Capsaicin

    • Topical capsaicin can effectively treat neuropathic pain conditions, such as diabetic neuropathy and postherpetic neuralgia.

    Second-Line Treatments for Neuropathic Pain

    • Antidepressants and anticonvulsants are often considered second-line treatments when first-line approaches fail or are inadequate.

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    Description

    Test your knowledge on classifying chronic pain with this informative quiz. Learn about the different types of chronic pain, including inflammatory pain, and understand how it can impact various aspects of life. Explore the multidimensional nature of chronic pain and its potential consequences.

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