BBH 101 Final Exam Study Guide with
Questions and Correct Answers
Chronic pain ✅refers to pain that lasts for a prolonged period of time, and over 100
million Americans are suffering with it
Very common medical problem ✅- It is the most common reason for Americans to
seek medical treatment, often manifesting as low back pain, headache (or migraine)
pain, or neck pain.
- Indeed, chronic pain is one of the most troublesome problems we face today as it
leads to hundreds of billions of dollars lost each year due to treatment costs and lost
productivity.
- also has made potent analgesic medications commonplace, along with the abuse and
addiction issues that are inseparable from these drugs.
Pain physiology overview ✅-Pain signals start at receptors situated throughout your
body that are specialized to detect things like tissue damage or other events related to
injury
- (Nociceptors ->spinal cord -> somatosensory cortex) order of pains signals from body
to pain
Nociceptors ✅receptors that send a signal along neurons that travel to the spinal cord.
Spinal cord ✅Nerves that run up and down the length of the back and transmit most
messages between the body and brain
Somatosensory cortex ✅deals primarily with bodily sensations, and so it is here that
the pain signals arrive to alert your brain to some potentially dangerous stimulus in the
environment
Factors that influence pain ✅age, gender, SES, culture factors
Age ✅Older individuals report pain more frequently. This may be due to declining
overall health, the increased likelihood of suffering from other conditions that might
cause pain, or decreased coping ability.
Gender ✅Females report pain more frequently than males; they also are inclined to
rate pain as more intense than a male would. It is unclear, however, if women actually
experience pain more than men. It may also be the case that men are just more
reluctant to talk about the pain they experience.
A variety of sociocultural factors may also play a role in the experience of pain.
,Socioeconomic Factors ✅Low socioeconomic status (SES), for example, is linked to
increased pain frequency and intensity. There may be a number of reasons for this
association, as people with low SES often have poorer medical care, fewer resources to
utilize to cope with pain, and increased levels of stress, which may exacerbate chronic
pain.
Cultural Factors ✅Cultural factors may also influence the way one experiences pain.
Different cultures and societies have established norms for how open people should be
about the pain they experience, and this causes people to perceive pain differently. For
example, for those who live on an island in the South Pacific called Yap, the pain of
childbirth is greatly de-emphasized. Yap women will often continue their daily activities
until the point that labor begins; then they will stop to have the baby and return to their
daily activities soon after. The event is viewed as somewhat commonplace, and pain
isn't given a large role to play in it. Thus, the cultural influence on pain can clearly be
significant if it can diminish the pain involved in an experience like childbirth.
Treatment for Pain ✅nsaids and Opioid Analgesics
Nsaids ✅-medication that exerts analgesic and anti-inflammatory actions
-most popular over-the-counter medications used to treat pain
- includes aspirin and ibuprofen
Inhibit cyclooxygenase (why does this help with pain/inflammation?) ✅- nsaids work by
lowering levels of lipid compounds called prostaglandins, which are involved in the
inflammatory response.
- They accomplish this by inhibiting an enzyme called cyclooxygenase that is involved in
the production of prostaglandins; by doing so, they inhibit prostaglandin production and
inhibit the inflammatory response. -Because a prolonged inflammatory response (which
can lead to swelling, tenderness, and pain) is often part of prolonged pain, reducing
inflammation often reduces pain.
Why is Acetaminophen technically not part of NSAID? ✅Because it does not relieve
inflammation
Opioid analgesics ✅Synthetic pain-relieving substances that were originally derived
from the opium poppy, Naturally occurring opium derivatives are called opiates.
Opioid ✅- refers to the fact that opioid drugs are related to substances found within the
seed pod of a flower known as the opium poppy.
- When you cut open the seed pod of the opium poppy, a thick milky fluid flows out.
-That fluid is rich in pain-relieving substances like morphine and codeine.
Analgesic ✅refers to a treatment that relieves pain
, Opiates vs. Opioids (what's the difference?) ✅- opiates refers specifically to the
substances that are found naturally in the opium poppy.
- The term opioid refers to substances that are at least partially synthetic, but are
derived from or related to opiates.
Opioid analgesics mechanism of action ✅They act on receptors throughout the
nervous system called opioid receptors.
Inhibit release of pain neurotransmitters ✅Once activated, opioid receptors initiate
mechanisms that inhibit the release of neurotransmitters involved in pain signaling
Cause release of endogenous opiates ✅produced naturally by the body that have
pain-relieving effects.
Anxiolytic effects, along with euphoria & sedation ✅In addition, opioid analgesics
cause increased GABA activity in the brain, which may help to reduce the anxiety
associated with pain. Thus, these are powerful drugs that not only inhibit sensations of
pain but make a person who is taking them feel all-around better and more relaxed.
Complications of opioid analgesics ✅- Because of the pleasant feelings they induce,
however, they also have high abuse potential.
High abuse & addiction potential ✅- A patient taking opioid drugs does not have to
abuse them to experience complications related to physical dependence on the drug,
however.
- Even patients who take opioid drugs as prescribed are at risk of their body becoming
dependent on them.
Tolerance/withdrawal ✅- When someone takes opioid drugs for a prolonged period of
time, their endogenous opioid system becomes dysregulated.
- This causes them to experience low levels of endogenous opioid activity, and when
they stop taking the drug they experience effects that are in many ways opposite to the
effects caused by the drugs.
- These include symptoms like tremors, increased sensitivity to pain, anxiety, and
insomnia.
- This withdrawal syndrome can last for several days and be extremely uncomfortable
(although not deadly).
- The overarching effect of these effects is to make the patient want to continue using
the drug, just to alleviate the withdrawal effects.
Risk of overdose - often due to respiratory depression, why? ✅- opioid drugs carry with
them a risk of overdose.
-The overdose from opioid analgesics is generally associated with respiratory
depression, which involves breathing slowing to the point where gas exchange can't
effectively occur in the lungs.
