Non-Opioid Analgesics

Question 1

Give some examples of non-opioid analgesics.

Answer 1

Ibuprofen, paracetamol, aspirin, nefopam, naproxen.

Question 2

What is aspirin indicated for?

Answer 2

Headaches, transient musculoskeletal pain, dysmenorrhoea, pyrexia.

Question 3

Why should patient be advised to take aspirin with food?

Answer 3

To avoid gastric side effects.

Question 4

Why is paracetamol generally preferred to aspirin or NSAIDs for analgesia, especially in the elderly?

Answer 4

It is less irritant to the stomach.

Question 5

What is nefopam indicated for?

Answer 5

The relief of persistent pain unresponsive to other non-opioid analgesics.

Question 6

What side effects of nefopam may be troublesome?

Answer 6

Antimuscarinic side effects - urinary retention, dry mouth, dilation of the pupils, hot and flushed skin.

Question 7

For what are NSAIDs commonly prescribed?

Answer 7

Chronic and short term treatment of mild to moderate pain, especially musculoskeletal pain.

Question 8

What additional treatment is required during long term treatment with NSAISs?

Answer 8

Stomach protection with a PPI or a H2-antagonist.

Question 9

What alternative to NSAIDs may be used in patients at a high risk from serious GI side effects?

Answer 9

COX2 inhibitors.

Question 10

What is the dose of ibuprofen for post immunisation pyrexia in a 2–3-month-old infant?

Answer 10

50mg as a single dose, repeated once every 6 hours if needed.

Question 11

What is the oral dose of ibuprofen for a 1–3-month-old infant?

Answer 11

5mg/kg QDS.

Question 12

What is the oral dose of ibuprofen for a 3-6-month-old infant?

Answer 12

50mg TDS.

Question 13

What is the oral dose of ibuprofen for a child aged 6-months to one year?

Answer 13

50mg QDS.

Question 14

What is the oral dose of ibuprofen for a child aged 1-4 years?

Answer 14

100mg TDS.

Question 15

What is the oral dose of ibuprofen for a child aged 4-7 years?

Answer 15

200mg TDS.

Question 16

What is the oral dose of ibuprofen for a child aged 10-12 years?

Answer 16

300mg TDS.

Question 17

What is the oral dose of ibuprofen for a child aged 12 to an adult?

Answer 17

Initially 300-400mg QDS, increased if necessary, to a max of 600mg QDS.

Question 18

In which patients is there an increased risk of paracetamol toxicity?

Answer 18

Those with a body weight under 50kg and those at a risk of hepatotoxicity.

Question 19

Is paracetamol licensed for oral administration in children under 2 months old?

Answer 19

No.

Question 20

What is the dose of paracetamol for post immunisation pyrexia in infants aged 2-4 months?

Answer 20

60mg as a single dose, repeated once every 4-6 hours if needed. Max 4 doses in 24 hours.

Question 21

What is the oral dose of paracetamol for child aged 1-3 months?

Answer 21

30-60mg TDS.

Question 22

What is the oral dose of paracetamol for a child aged 3-6 months?

Answer 22

60mg QDS.

Question 23

What is the oral dose of paracetamol for a child aged 6 months to 1 year?

Answer 23

120mg QDS.

Question 24

What is the oral dose of paracetamol for a child ages 2-4 years?

Answer 24

180mg QDS.

Question 25

What is the oral dose of paracetamol for a child aged 4-6 years?

Answer 25

240mg QDS.

Question 26

What is the oral dose of paracetamol for a child aged 6-8 years?

Answer 26

240-250 mg QDS.

Question 27

What is the oral dose of paracetamol for a child aged 8-10 years?

Answer 27

360-375mg QDS.

Question 28

What is the oral dose of paracetamol for a child aged 10-12 years?

Answer 28

480-500mg QDS.

Question 29

What is the oral dose of paracetamol for a child aged 12-16 years?

Answer 29

480-750mg QDS.

Question 30

What is the oral dose of paracetamol for patients aged 16 and above?

Answer 30

500mg-1g QDS.