External Analgesics Flashcards
Before administering a external analgesic what are the question that you should ask the patient and why
How long is the pain and what kind of pain it is.
What May be the cause of the pain
Can you locate the pain
Is it a joint pain
Always arrange follow up consultant to ensure that patient doesn’t keep using the topical without seeing a doctors
Apply : SOCRATES
S- site
O - onset of pain
C- character of the pain -wat is it like
R- any radiation of the pain
A - any associated symptoms
T- time - does the pain have any pattern
E - exarcerbating - anything relieve the pain
S - severity of the pain
Arrange the following counter irritant in terms of potency
Methyl salicylate , terpentine oil and ammonia ,
Capsaicin capsicum
Menthol camphor
Name non -drug methods of relieving pain
Heat pads or sream packs - increase viscous flow
Massaging the area
Relaxation technique
Copper Magnetic Bracelet ( magnetic therapy )
Tiger balm
Name the diclofenac based topical ointment
Omnigel
Voltaren gel
Go go gell diclofenac
What are some other non pharmalogical aspect of pain relieve outcomes that need to consider when treating a patient with chronic pain
Biopeychosocial aspect - look at the biological aspect , psychological and social aspect of the patient that may worsen the pain conditions .
What are the factors to consider when choosing a pain medication
By how much you want to relieve the pain
Side effects
Addiction issue
What does Ceiling effect mean of analgesic
Higher dose will not give any additional benefits
How does NSAID works
block a specific enzyme called cyclooxygenase (or COX) used by the body to make prostaglandins.
Prostaglandin -
sensitize nerve to pain
Increase inflammation
Vasoconstriction
Protect mucus in stomach
Helps with fever
Remember prostaglandin cause the formation thromboxane 2 that is needed to blood cloth ( Asparin )
Remember they cause increase of luekotriens that can worsen asthma
Acetomenophen MOA
Block cox enzymes at the central nervous system
Common side effects of codeine MOA and available dose
binds to mu-opioid receptors, which are involved in the transmission of pain throughout the body and central nervous system
Drowsiness
Constipation
Dry mouth
30 - 60 mg q4-6h
Available dose of morphine in JA
As
Mist - 5mg 10mg 100mg / 5 ml
Tab 10 mg 30 mg 60 mg
Injection 10 mg/ ml and 15 mg/ ml
Which opioid can be used in renal failure
Fentanyl
What is the Iv / I’m / sc 10 mg Morphine in oral
30 mg oral tablet
How much is 75 mg Iv/ im / sc pethidine quivalence in oral
375 mg oral
What’s the 5 mg iv/ im/ sc oxycodone oral
20 mg oral tablet
