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Research proposal (Paracetamol (Not very anti-inflammitory (So not a…

- - - - induced by spinal anastesia
      - unmasking or sprouting of connections
      - Central sensitization
        
        axonal sprouts in SC
        
        Increase in NMDA receptor activity
        
        mediated by substance P, tachykinin and neurokinins
        
        windup phenomenon
        
        upregulation of the receptors
      - reduction of inhibition
    - - increased activity of peripheral nociceptors
        
        permanent change in synaptic structure of dorsal horn
        (central sensitisation)
        
        increased exitability of dorsal-horn neurons
        
        from destroyed interneurons
        
        reduction in inhibition
        
        structural changes at central nerve endings
        
        mediated by NMDA and glutamate
        
        Peripheral nerve injury
        
        Degeneration of C-fiber
        
        sprouting of A-fiber
        
        may be interpreted as noxious
        
        Loss of input
        
        general disinhibition
        
        3 more items...
    - - In neuropeptides
        
        (substance P)
        
        Become expressed in A-beta fibers io C and A-delta
        
        hyperexitability of spinal cord
    - - Neuromatrix
        
        abnormal input
        
        altered neurosignature
        
        phantom
        
        network of neurons in several areas that are unique
      - cortical reorganization
      - body schema
    - - cut/injured nerves
        
        disruption of input
        
        deafferentiation
        
        regenration/sprouting of axons
        
        increased spontaneous activity
        
        neuromas
        
        increased accumulation of molecules
        
        1 more item...
      - reorganization of neural networks
  - - - animal model of neuropathic pain
  - - - NSAIDs
        
        most common
        
        inhibit enzymes needed for synthesis of prostaglandin
      - Opioids
        
        benefits but also side effects
      - antidepressants
        
        tricyclic antidepressants
        
        inhibition of serotonin-nerepinephrine uptake blockade
        
        NMDA receptor antagonist
        
        sodium channel blockade
      - NMDA antagonist
- - - - prostaglandine
        
        hormone like
        
        causes pain
        
        Vasodialation
        
        From damaged cells
- - - - Thermal
        
        temperature
      - Mechanical
        
        pressure
      - polymodal
        
        temperature, pressure, chemical
        
        non-mylenated
    - - A
        
        fast, mylenated
      - C
        
        Slow, unbylenated
    - - threshold reduced by inflammation
    - - conducts pain
        
        capsaicin/vanillooid receptor
    - - Glutamate
        
        AMPA
      - Substance P
        
        neuropeptide
        
        released from C fibers
        
        released with Glu
        
        enhances it
        
        no reuptake
    - - gate control theory
      - TENS (transcutaneous electrical nerve stimulation)
  - - - activates polymodal nociceptors
    - - canabinoid agonist
      - inflammation
    - - released from damaged cells
        
        sensitize nociceptor by triggering prostaglandin and bradykinin
    - - elevated in nociceptive neurons under condition of inflammatory and neurophathic pain
        
        inhibtion?
  - - - activated by nocicetive stimuli
      - lesion
        
        no emotional response to pain