GP

Question 1

What is the analgesic ladder?

Answer 1

1 - non opioid (aspirin, paracetamol, NSAID) +/- adjuvant
2 - weak opioid (codeine) +/- non opioid +/- adjuvant
3 - strong opioid (morphine) +/- non opioid +/- adjuvant

Question 2

How do opioids work?

Answer 2

block pain transmission by binding to receptors in the CNS

Question 3

What can be used as non pharmalogical pain relief?

Answer 3

acupunctures, TENs machine, heat/ice, yoga, exercise, herbal, psychophysiological therapy, ablimen bust cycle, plan days, occupational therapy

Question 4

What drugs can be given alongside the analgesic ladder?

Answer 4

gabapentin, pregabalin, antitriptyline

Question 5

Side effects of opioids?

Answer 5

resp depression, nausea, constipation, drowsiness

Question 6

Side effects of NSAIDs?

Answer 6

nausea, diarrhea, insomnia, abdominal pain, headaches, stomach ulcers

Question 7

Side effects of COX-1?

Answer 7

stomach ulcers, intestinal bleeding (safer than NSAIDs for stomach)

Question 8

What risks are there in pain killers?

Answer 8

watch if on alcohol or antidepressants, can gain tolerance, can gain dependence on the drug, get muscle pain and irritability

Question 9

What is the QoL scale?

Answer 9

measures function for people with pain, developed by American Chronic Pain Association (ACPA) and should be completed when first seeking treatment, shows effect on work, social, exercise, household chores, mood and ranked 1-10, involves a pain diary or when, where, severity and relieving fatcors

Question 10

Physiological effects of chronic pain?

Answer 10

reduced ability to work due to future uncertainty and balancing multiple roles, difficulty performing every day tasks, physical disability, problems with medication of side effects, interactions and dependence, becoming physically drained, stop doing things they enjoy

Question 11

Psychological effects of pain?

Answer 11

marital and family problems, depression, increased suicidal thoughts and suicide attempts, sleep disturbance, helplessness, become irritable, short tempered, impatient, limit social contact, difficulty focusing on simple tasks, anxiety, loss of self esteem

Question 12

Risk factors for depression?

Answer 12

low self esteem, being too dependent, self critical, pessimistic, traumatic event, bereavement, family history, being different (gay), abuse of alcohol and drugs, medications, chronic illness

Question 13

Psychological symptoms of depression?

Answer 13

continuous low mood, feeling hopeless and helpless, feeling tearful, feeling guilt ridden, irritable, no motivation, lost interest, poor decision making, not enjoying life, feeling anxious, suicidal thoughts

Question 14

Physical symptoms of depression?

Answer 14

moving or speaking more slowly, change in appetite or weight, constipation, unexplained aches and pains, lack of energy or loss of libido, changes to menstrual cycle, disturbed sleep

Question 15

Social symptoms of depression?

Answer 15

not doing well at work, taking part in fewer activities, avoiding contact with friends, neglecting hobbies, difficulties in home and family life

Question 16

How are chronic pain and depression linked?

Answer 16

they can exacerbate and make each other worse, and if you have one you are more likely to have the other, treating one can also help the other

Question 17

In who is depression most common?

Answer 17

illness of affluence, occupational stress, poverty, inequality between society