Management of Pain and Inflammation in Orthopaedics

Question 1

List the main routes of administration of drugs

Answer 1

Intravenous, intramuscular, subcutaneous, tpical, inhaled, transdermal, intrathecal, sublingual, rectal, Oral - portal circulation

Question 2

describe the route of oral drugs

Answer 2

swallowed, absorbed, distributed (Intra, extra vascular space), metabolism, to Billary, intestinal and renal excretion

Question 3

Describe the basic route of a drug in Parmokinetics

Answer 3

Administration, absorption, distribution, metabolism and finally excretion

Question 4

What are Analgesics for?

Answer 4

Inflammatory pain

TIssue damage or central nervous system pain - neuropathic pain

Question 5

What are some examples of analgesics

Answer 5

Pain - paracetamol
Inflam and pain - Aspirin, NSAIDS, COX2 inhibitors - Celocoxib, Etoricoxib and meloxicam
Muscle spasm- Diazapan, benzodiaepine

Question 6

List some risks of NSAIDS

Answer 6

Nasuea, heartburn, indigestions, gastric bleeding, increase of CV events, doubles risk of heart failure

Question 7

WHat are precautions to taking NSAIDS

Answer 7

Already on other medications like blood thinggers or corticosteroids, have other medical conditions such as an ulcer and high blood pressure, over 65 years, taking another medicine that includes NSAID, drink alcohol, have more than recommended does and take NSAIDS more than a few days at a time

Question 8

What are some examples of NSAID brand names

Answer 8

Celebrex, Feldine Lodine, Mobic, Voltaren, Naprosyn

Question 9

What are some side effects of opiods

Answer 9

Nausea, vomitting, itching , constipation, respiratory depression

Question 10

List some common opioids

Answer 10

Codiene, fentanyl, oxycodon, morphine

Question 11

What is a general anaesthetic?

Answer 11

Local anaestehic is a few hours of pain relief of a joint. You can not feel anything going on there

Question 12

What is an epidural

Answer 12

delivers anaesthetic by catheter slowly into the epidura around the spine. Causes loss of sensation from the point of insertion down

Question 13

WHat are the implications of epidurals or spinal blocks for physiotherapy

Answer 13

Cannot get someone up to mobilise until the epidural is removed and muscle strength has returned

Question 14

What is a femoral nerve block

Answer 14

a form of anaestehic used numb the thigh. Used in TKA

Question 15

What are some complications of a Femoral nerve block

Answer 15

Nerve injury, femoral nerve, block quadriceps High fall risk

Question 16

Where is a saphenous block applied

Answer 16

In the saphenous nerve in the adductor canal. Requires ultrasound

Question 17

What are some examples of multimoadal analgesia?

Answer 17

Epidrual anaestehtic
General anaestehtic + periarticular anaestehtic + PCA
General Anaestehtic + femoral Nerve block
GA + Periarticular anaesthetic + ice

Question 18

What is a PCA?

Answer 18

Patient controlled analgesia

Question 19

WHat are some drugs that can be in PCA

Answer 19

Morphine, hydromorpone, fentanyl, sufentanil, Meperidin, Tramadol

Question 20

Describe a Saphenous nerve block

Answer 20

Largest cutaneous branch of femoral nerve, supplies medial knee, medial lower leg. Idea is that it will numb distal though, knee and lower leg. Spares quads