Chapter 4 BNF (Pain) Flashcards
What’s best for MSK pain?
Non opioids
NSAIDs
What’s best for dental pain?
NSAIDs
Find cause
What can be offered for period pain?
Oral contraceptives
Antispasmodics
Non opioids
What can be offered for nerve compression by a tumour?
Dexamethasone
What dose aspirin should be given in medical emergencies?
Aspirin 300mg dispersinble or chewable. NOT Gastro resistant
What’s the aspirin dose for pain?
300-900mg every 4-6 hours
Max 4G
When can aspirin be used in under 16?
Kayaking disease as an antiplatelet
What’s the dose of breakthrough pain
1 tenth to 1 sixth of the total daily dose every 2-4 hrs when required
What can be given for opioid overdose?
Naloxone
What are the side effects of opioid!
Dry mouth Nausea and vomiting Constipation Sedation Euphoria
Which opioid side effects doesn’t improve with time?
Constipation
What side effects can occur with larger doses of opioids?
Hypotension
Muscle rigidity
Pupil constriction
What side effects can occur with long term use of opioid?
Hypogonadism
Adrenal insufficiency
HYPERALGESIA
When should opioids NOT be given?
Comatose patients
Paralytic ileus
Asthma attack and COPD
How often is standard release morphine given?
Every 4 hours
How often is MR morphine given?
Every 12/24 hours
What is the maximum dose increase increments for morphine ?
1/3 to 1/2 every 24hrs
How must the morphine dose be adjusted going from oral to IV/IM/SC?
1/2
How must the morphine dose be adjusted going from oral to IV/IM/SC diamorphine?
1/3
What is the mechanism of action for buprenorphine?
Partial opioid agonist
How does naloxone affect buprenorphine?
Partially
How must buprenorphine be separated with other opioids?
24 hrs
What’s the risk with opioid naive patients and fentanyl
Respiratory depression
When should fentanyl patients be removed IMMEDIATELY?
Breathing difficulties
Confusion
Dizziness
