Non-Malignant Pain part 1 Flashcards
What is pain?
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
What does the ‘PQRSTU’ mnemonic stand for in pain assessment?
- Palliative or Precipitating factors
- Quality of pain
- Region of pain location
- Severity (pain assessment instruments)
- Time-related nature of pain
- Impact of pain on you
List the objective information used to assess pain.
- Behavioral changes
- Physiological changes
- Dilated pupils (mydriasis)
- Paleness (pallor)
- Sweating (diaphoresis)
- Tachycardia
- Tachypnea
What are the pain intensity scales used in pain assessment?
- Verbal
- Numeric
- Visual
- Wong-Baker
Who do the CDC guidelines for prescribing opioids apply to?
Outpatients aged ≥18 years with acute, subacute, or chronic pain.
What is the recommended dosing for acetaminophen (Tylenol) in adults?
325 -1000mg PO Q4-6H PRN (max dose ≤3-4 g/day).
What are some side effects of acetaminophen?
Hepatotoxicity, particularly with doses ≥10g.
What are the side effects of NSAIDs?
- GI bleeding (black box warning)
- Nephrotoxicity
- Fluid retention
- Increased CV events (black box warning)
What is Reye’s syndrome and with which medication is it associated?
A rare but serious condition causing brain and liver swelling, associated with children/teens using aspirin during viral infections.
What is the maximum recommended duration for ketorolac (Toradol) use?
5 days (for combined parenteral and oral use).increased risk of GI bleed when used longer
What is the recommended dosing for ibuprofen (Advil, Motrin) in adults?
200-800mg PO q6-8h PRN (max 3200mg/day).
Which NSAID is COX-2 selective and has less GI toxicity?
Celecoxib (Celebrex).
Fill in the blank: The recommended dosing for acetaminophen in pediatric patients is _______.
10-15 mg/kg PO Q4H PRN (max dose 75mg/kg/day or ≤3-4 g/day).
True or False: Acetaminophen is the gold standard for osteoarthritis due to fewer side effects in geriatric patients than NSAIDs.
True
What should be avoided in patients taking blood thinners or antiplatelets?
Aspirin (Bayer).
What are the available formulations of naproxen (Aleve, Naprosyn)?
- Capsule
- Tablet
- DR/ER tablet
- Suspension
What is the maximum recommended dose of aspirin (Bayer) for adults?
4g/day.
List the available formulations of diclofenac (Voltaren).
- Capsule
- Tablet
- IV solution
- Suppository
- Topical gel
- Topical solution
- Ophthalmic solution
- Patch
What are non-pharm therapy options
Can be used in combination with analgesics
Physical manipulation
Heat or Ice
Massage
Acupuncture
Exercise
Correct the underlying cause (surgery, avoidance)
What is a treatment approach
WHO analgesic ladder (step up if pain persisting or increasing)
step down if pain is resolving
what is step 1
Non-opioid
+/- adjuvant
analgesic
what is step 2
Opioid for mild-
moderate pain
+ Non-opioid
+/- adjuvant
analgesic
what is step 3
Opioid for
moderate-severe
pain
+ Non-opioid
+/- adjuvant
analgesic
Select the non-opioids
A. acetaminophen
B.gabapentinoids
C. topical agents
D. NSAIDS
A and D
