3 step Analgesic Ladder

Question 1

Define nociceptive pain

Answer 1

occurs when there is damage to body tissue caused by external stimuli

Question 2

Define neuropathic pain

Answer 2

“occurs when the health condition affects the nerves that carry sensations to your brain”

Question 3

Theres 4 options

Outline some non-pharmalogical approaches to treat pain

Answer 3

1. Meditation and yoga
2. Physiotherapy
3. RICE
4. Acupuncture

Question 4

Outline the components of RICE

Answer 4

Rest: keep the injured area supported - don’t use for 48 to 72 hours
Ice: for 20 minutes every 2 hours
Compression: firm elastic bandage
Elevation: raise area above heart

Question 5

Outline the role of simple analgesics and examples
(Ist group in the 3 step analgesic ladder)

Answer 5

Role: treats mild acute and chronic pain of nociceptive origin/reduces swelling and inflammation

Non-opoid analgesics:
1. Paracetomal
2. NSAIDS such as Ibuprofen, Diclofenac, Mefanamic Acid, Naproxen, Aspirin - treats migraine, headache, dental pain, muscle aches, backache , period pain

Question 6

Outline the role of weak opoid analgesics and examples
(2st group in the 3 step analgesic ladder)

Answer 6

Role: treats moderate acute and chronic pain because of damage to tissue

1. codeine, oxycodone, tramadol

Question 7

Outline the role of opoid analgesics and examples with adverse effects
(3rd group in the 3 step analgesic ladder)

Answer 7

severe acute and chronic pain of nociceptive origin

1. Morphine, fentanyl - sedation, constipation, falls

Question 8

What happens when the cells are injured?

Answer 8

1. arachnoid acid is released into the cytosol
2. • Cyclo-oxygenase enzyme 1 (present always) converts the acid into prostaglandins that promote haemostasis and protection of gastric mucosa.
3. • COX 2 (only present in the event of inflammation) produces prostaglandins that mediate pain, inflammation and fever

Question 9

NSAIDS are strictly contradicted/not recommended in pregnancy. Is this a correct statement?

Answer 9

YES

Question 10

Define adjuvant analgesics

Answer 10

• co-administered with analgesics to relieve increasing and strong pain

Question 12

List the 3-step analgesic ladder

Answer 12

1. Simple analgesics +- adjuvant analgesic
2. Weak opoid + simple analgesics +- adjuvant analgesics
3. Strong opoid + simple analgesics +-adjuvant analgesics

Question 13

Is paracetamol a safe and effective med?

Answer 13

YES, very safe for thereaputic use

Question 14

Whats the dose of paracetamol?

Answer 14

1 g 4 times per day (max 8 per day for adults)

Question 15

List 2 limitations of NSAIDS

Answer 15

1. Cannot target specific part of body
2. Long term use can cause adverse effects
3. Only effective when used for short term

Question 16

Topical NSAIDS are generally less effective than oral NSAIDS. Is this a correct statement

Answer 16

YES