10 Questions
What is the primary target of NSAIDs in pain relief?
Site of injury/painful stimulus
What type of pain is treated with Amitriptyline?
Neuropathic pain
Which medication is contraindicated in asthmatics and those with gastric problems?
Ibuprofen
What is the specific use of Mefenamic acid?
Period pain
What is the mechanism of action of Tramadol?
μ-opioid receptor agonist
Which type of pain is addressed by the first step of the analgesic ladder?
Inflammatory pain
What is the mechanism of action of Cox inhibitors?
Inhibit the production of prostaglandins
Which medication is used for analgesia in the descending control pathway?
Paracetamol
What is the site of action of Amitriptyline and similar medications?
Dorsal horn neurons
What is the common feature of medications in the first step of the analgesic ladder?
They are all Cox inhibitors
Study Notes
Analgesic Ladder
- The analgesic ladder mirrors the pain pathway
Step 1: NSAIDs
- Site of action: site of injury/painful stimulus
- Mechanism of action: Cox inhibitors, inhibit production of prostaglandins
- Examples: ibuprofen, Naproxen, Diclofenac
- Contraindications: asthmatics and those with gastric problems
- Specialized indication: mefenamic acid for period pain (menorrhagia)
Step 2: Analgesia
- Site of action: descending control
- Examples: Paracetamol, Codeine-based (e.g., co-codamol), Tramadol
- Note: Tramadol is a very weak μ-opioid receptor agonist
- Also includes: Morphine
Step 3: Neuropathic Pain
- Site of action: spinal (dorsal horn neurons)
- Examples: Amitriptyline, Gabapentin, Pregabalin
Analgesic Ladder
- The analgesic ladder mirrors the pain pathway
Step 1: NSAIDs
- Site of action: site of injury/painful stimulus
- Mechanism of action: Cox inhibitors, inhibit production of prostaglandins
- Examples: ibuprofen, Naproxen, Diclofenac
- Contraindications: asthmatics and those with gastric problems
- Specialized indication: mefenamic acid for period pain (menorrhagia)
Step 2: Analgesia
- Site of action: descending control
- Examples: Paracetamol, Codeine-based (e.g., co-codamol), Tramadol
- Note: Tramadol is a very weak μ-opioid receptor agonist
- Also includes: Morphine
Step 3: Neuropathic Pain
- Site of action: spinal (dorsal horn neurons)
- Examples: Amitriptyline, Gabapentin, Pregabalin
Explore the analgesic ladder, a step-by-step approach to pain management. Learn about the different stages, mechanisms of action, and examples of medications used to alleviate pain.
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