Analgesia Flashcards
Define acute pain
<3 months
What type of pain tends to be acute?
Nociceptive
What type of pain tends to be chronic?
Neuropathic
Adverse effects of pain (6)
Decr Resp excursios –> hypovent + collapse
GI atony
Bladder atony –> retention
CAH release –> VC –> incr cardiac work
Decr wound perfusion + healing
Psychological
Step 1 WHO pain ladder
Non-opioid +/- adjuvant
Step 2 WHO pain ladder
Weak opioid +/- non-opioid +/- adjuvant
Step 3 WHO pain ladder
Strong opioid +/- non-opioid +/- adjuvant
E.g.s weak opioid
Codeine
Tramadol
E.g.s of strong opioids
Morphine Fentanyl Oxycodone Hydromorphone Buprenorphine
E.g.s of adjuvants used on WHO pain ladder (6)
Anti-Ds Anticonvulsants Antispasmodics Mm relaxant Bisphosphonates CCS
Dose paracetamol
1g ev 4-6hr oral
Or IV 1g over 15mins
Max dose paracetamol /day
4g
NSAIDS indications
Pain + inflamm MSK disorders
Cautions NSAIDS (4)
Breast feeding
Hypersensitivity
AKI/CKD
Elderly
C/I NSAIDS (2)
HF
Peptic ulcer
Dose NSAID
300-400mg daily
Max dose NSAIDs /day
2.4g
Cautions codeine (4)
Impaired resp function
HOTN
Shock
Asthma attacks
C/I codeine
Acute resp depression
SE codeine (3)
N/V
Dry mouth
Constipation
Dose codeine
30-60mg ev 4 hrs
Max dose codeine /day
240mg
What co-prescription does morphine require?
Anti-emetic
dose- acute pain Morphine
10-15mg every 2-4h
Dose - MI - morphine
Slow IV 1mg/min for 5mg
Dose - Acute pulmonary oedema - morphine
5-10mg PO/SC/IM ev 4hr
