Analgesics

Question 1

What will a patient benefit from if they have dental pain?

Answer 1

mouthwash or a spray such as benzydamine

patient may also need paracetamol - helps with the pain but wont help with swelling as its not an anti-inflammatory

can use dihydrocodiene - mild opioid

Question 2

Are opioids effective in dental pain?

Answer 2

Not v.effective and you only have an increase in S/E

Question 3

If a patient has been grinding/clenching their teeth, what could be given?

Answer 3

Diazepam as its a muscle relaxant

Question 4

If a patient has dysmenhorrea, what would they be given?

Answer 4

oral contraceptives
NSAIDS
antiemetic
or antispasmodics

Question 5

What’s the difference between feminax express and feminax ultra?

Answer 5

Feminax Express: Ibuprofen and Lyscine

Feminax Ultra: Naproxen

Question 6

Whats the difference between aspirin dispersible and aspiring enteric coated?

Answer 6

Dispersible: faster acting

E/C: good for nighttime pain

Question 7

What should you be careful when giving aspirin to patients? Why?

Answer 7

Don’t give to patients under 16

development of Reyes syndrome

Question 8

What are the symptoms of Reyes syndrome?

Answer 8

• vomiting
• Drowsiness
• Rapid breathing
• Seizures
  Severity of symptoms can increase to personality changes, delirium and even coma

Question 9

What’s Nefopam used in?

What is one of the counselling points for it?

Answer 9

Used in persistent pain when unresponsive to other opioids

It can make your urine PINK.

Question 10

What’s ziconotide used in?

Answer 10

used via intrathecal infusion in severe pain

Question 11

A cold remedy usually contains: 
Lemon 
Caffeine 
Paracetamol 
Why is that?

Answer 11

Lemon - flavouring
Caffeine - enhances analgesic effect
Paracetamol - pain relief

Question 12

When are opioid analgesics used?

Answer 12

for moderate to severe pain

Question 13

What are the issues with opioids?

Answer 13

patients can get tolerance and dependance problems so patient must be assessed regularly

Question 14

Name a few opioid analgesics?

Answer 14

Buprenorphine, morphine, pethidine, methadone, fentanyl, tapentadol, tramadol, codeine

Question 15

How does buprenorphine work? How long does it work for?

WHats the main problem with it?

Answer 15

works as an agonist and an antagonist.
It has a long-lasting effect (lasts 6-8 hours - the sublingual form)
problems with withdrawal

Question 16

What should you counsel on when giving fentanyl patches?

Answer 16

must be changed every 72 hours

Pt should stay away from a sauna

Question 17

Which pathways does tramadol work through?

Answer 17

adrenergic and serotenergic pathways

Question 18

What can tramadol interact with?

Answer 18

SSRI

causes serotonin syndrome

Question 19

What are the main side effects of opioids?

Answer 19

Constipation
N/V
dry mouth
Drowsiness