Analgesic Ladder

Question 1

What would you prescribe for patient with fever?

Answer 1

(as-required) Paracetamol PO 1g up to 6-hourly

Question 2

What would you prescribe for mild to mod pain?

Answer 2

(1) (regular) Paracetamol PO 1g 6-hourly

(2) (PRN) Codeine PO 300mg up to 6-hourly

Question 3

What would you prescribe for moderate to severe pain?

Answer 3

(1) (regular) Co-codamol 30/500 2 tablets, 6-hourly PO

(2) (PRN) Morphine sulphate (10mg/5ml) 10mg up to 6-hourly

Question 4

Analgesic pain ladder - step 1

Answer 4

Non-opioid (paracetamol OR NSAID) +/- adjuvant

Question 5

Analgesic pain ladder - step 2 (if pain persists or increases)

Answer 5

Weak opioid (codeine OR dihydrocodeine) +/- non-opioid +/- adjuvant

(1) (regular) paracetamol 1g 6-hourly PO
(2) (PRN) codeine 30mg up to 6-hourly PO

Question 6

Analgesic pain ladder - step 3 (if pain persists of increases)

Answer 6

Strong opioid (morphine, methadone, fentanyl, oxycodone, buprenorphine, oxymorphine) +/- non-opioid +/- adjuvant