Chronic Pain

Question 1

What is chronic pain

TQ*

Answer 1

Persistent pain after initating condition has healed (after 3 months)

and is not associated with malignant disease

Question 2

What is the first line treatment for chronic pain

Answer 2

non-opioids
NSAIDs, duloxetine, benzos

and PT, accupuncture, massage, exercise

Question 3

When should opioid therapy be initiated for chronic pain

Answer 3

failed trial of non-opioid therapy

Question 4

Examples of inital trial opioids

Answer 4

morphine, oxycodone, hydromorphone
codeine
tramadol

Question 5

What should not be used for first line opioids

Answer 5

methadone
fentanyl

Question 6

Who should avoid morphine

Answer 6

pts with renal insufficiency

Question 7

What is a reasonable trail of opioid therapy for chronic pain

Answer 7

3-6 months

Question 8

When does tolerance/withdrawl symptoms develop on opioids

Answer 8

2-4 weeks

Question 9

Who should not use opioids for chronic pain

Answer 9

people with a history of/or active substance use disorder

Question 10

What should an inital opioid dose be restricted to

Answer 10

<50mg morphine equvialents per day

Question 11

For patients on opioids and not seeing relief what should be done

Answer 11

rotate to different opioid

Question 12

First line treatment for neuropathic pain

Answer 12

antiepileptic meds like pregablin/gabapentin

and antidepressant meds like amitriptyline, duloxetine

Question 13

Question about whether to start narcotics for ankle pain

TQ*

Answer 13

answer okay to start narcotics