Hosam Mohamed-
pain caused by a lesion or disease of the somatosensory nervous system
What is Neuropathic Pain?
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ectopic activity in damaged nerve fibers and peripheral/central sensitization
What is the cause of Neuropathic Pain?
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nortriptyline, amitriptyline, Despiramine
What are the TCA? (3)
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duloxetine, venlafaxine, Milnacipran
What are the SNRIs? (3)
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inhibit presynaptic reuptake of 5-HT and NE; activates the descending pathways
Antidepressants MOA?
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act on central terminals of primary afferent fibers decreasing NT release/neuronal hyperexcitability
Antiepileptic drugs MOA?
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a,c
Which drugs are modulators of VGCC?
a) pregabalin
b) carbamazepine
c) gabapentin
d) Milnacipran
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b
Which drug is a Voltage-Gated Na+ modulator?
a) pregabalin
b) carbamazepine
c) gabapentin
d) Milnacipran
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gabapentin, pregabalin, carbamazepine
What are the antiepileptic drugs? (3)
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lidocaine, capsaicin, camphor
What are the topical adjuvants? (3)
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local anesthetic; use-dependent blockade of voltage-gated Na+ channels; stabilizes nerve membranes
Lidocaine MOA?
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TRPV1 agonists that cause desensitization of nociceptors through the depletion of substance P from afferent nerve fibers
Capsaicin MOA?
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Spasm
-involuntary contracts of the muscle.
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an upper motor neuron disorder that causes hypertonicity and involuntary spasms
What is Spasticity?
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jerks, twitches, cramps
Symptoms of Spasms? (3)
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stiffness, hypertonicity, hyperreflexia
Symptoms of Spasticity? (3)
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musculoskeletal pain, fibromyalgia, low back pain, disc herniation
Which conditions can cause spasms? (4)
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MS, cerebral palsy, spinal cord injury, stroke, traumatic brain injury
Which conditions can cause spasticity? (5)
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centrally; muscle
Antispasmodics act ______ and DO NOT act in ________ directly.
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1st; AE's and limited comparative efficacy
Antispasmodics are not _______ line drug options because of __________.
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2nd line or adjunct therapy when initial therapy fails
When are antispasmodics used?
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anticholinergic AE's; sedation, confusion, dry mouth, hallucinations
Antispasmodics AE's? (4)
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carisoprodol, cyclobenzaprine, metaxalone, methocarbamol, orphenadrine, chlorzoxazone
What are the Antispasmodic agents? (6)
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a,f
Which drugs have anticholinergic and antihistaminic effects?
a) Orphenadrine
b) Metaxalone
c) Carisoprodol
d) Cyclobenzaprine
e) Methocarbamol
f) Chlorzoxazone
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c
Which drug is a Schedule IV?
a) Orphenadrine
b) Metaxalone
c) Carisoprodol
d) Cyclobenzaprine
e) Methocarbamol
f) Chlorzoxazone
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d
Which drug is structurally similar to TCA and potentiates other CNS
depressants?
a) Orphenadrine
b) Metaxalone
c) Carisoprodol
d) Cyclobenzaprine
e) Methocarbamol
f) Chlorzoxazone
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e
Which drug can cause urine to turn brown, green, or black?
a) Orphenadrine
b) Metaxalone
c) Carisoprodol
d) Cyclobenzaprine
e) Methocarbamol
f) Chlorzoxazone
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b
Which can cause hepatotoxicity?
a) Orphenadrine
b) Metaxalone
c) Carisoprodol
d) Cyclobenzaprine
e) Methocarbamol
f) Chlorzoxazone
