Pain & Inflammation

Question 1

Inflammation: histamines

Answer 1

Increased vascular permeability

Endothelial activation

Vasodilation

Question 2

Inflammation: 5HT

Answer 2

Vasodilation, increased vascular permeability.

Question 3

Inflammation: prostaglandins

Answer 3

Pain
Vasodilation
Fever

Question 4

Inflammation: leukotrienes

Answer 4

Increased permeability
Chemotaxis
Leukocyte adhesion and activation

Question 5

Inflammation: kinins

Answer 5

Increased vascular permeability
Vasodilation
Pain

Question 6

Nonsteroidal anti-inflammatory drugs

Answer 6

Mild to moderate pain and inflammation.

Block cox-1/2

Acetaminophen, ibuprofen, naproxen, dicofenac.

Anti-inflammatory (except acetaminophen)
Analgesic
Antipyretic
Anticoagulant

Question 7

Aspirin

Answer 7

First NSAID

As well as pain and inflammation; also anticoagulant.

Question 8

NSAIDs: Adverse effects

Answer 8

Damage to gastric mucosa

Nephrotoxicity

Coagulation

Question 9

Opiates: effects

Answer 9

Analgesic
Anti-diarrheal
Anti-tussive
Anti-anxiety

Question 10

Narcotics: mechanism of action

Answer 10

• altering Na+/K+ flow in and out of cell

- affect cellular second messenger system

Question 11

Narcotics: adverse effects

Answer 11

Hypotension
Hypoventilation
Constipation
Delirium
Sedation
Urinary retention
Habit forming.

Question 12

Skeletal muscle relaxants

Answer 12

Reduce muscle spasm and spasticity

Depresses sensory and motor impulses at different sites in the CNS

Question 13

Muscle spasm

Answer 13

Abnormally high muscle tone.

response to trauma, or unexpected trauma

Splinting

Question 14

Spasticity

Answer 14

Hypertonicity, clonus, exaggerated reflux

CNS damage

Question 15

Muscle relaxant: uses

Answer 15

Central: inhibit painful mm HT from injury/inflammation

Peripheral: management of spasticity and adjective to general anaesthetic.

Question 16

Muscle relaxants: adverse effects

Answer 16

Drowsiness
Dry mouth
Heart rate abnormalities
Dizziness

Question 17

Two main events in inflammation

Answer 17

1. Change in caliber and permeability of blood vessels
2. Emigration of leukocytes from bloodstream to inflamed area
   Neutrophils first, then macrophages

Question 18

Why is acetaminophen weird?

Answer 18

Doesn’t work at site of inflammation; limits pain and fever by acting in CNS only.

Thought to be inactivated by peroxide – inflammatory byproduct.

Question 19

Four categories of corticosteroids action

Answer 19

1. Anti Inflammatory
2. Immunosuppressive
3. Catabolic effect on connective tissue
4. Other. (Increased Na+ resorption, mood changes, decreased Ca+ absorption, impaired osteoblast activity).

Question 20

Corticosteroids : physiologic dose

Answer 20

Small. Replacing natural production.

Question 21

Corticosteroids: pharmacologic dose

Answer 21

Large. To achieve anti inflammatory and immunosuppressive effects.

Question 22

Corticosteroids: adverse effects

Answer 22

Hypertension
Diabetes
Avascular necrosis
Weakened connective tissue
Mood disturbances
Osteoporosis