Oncology drugs Flashcards
What was the WHO pain ladder originally designed for?
To guide the treatment of pain relief in cancer patients
What is step 1 on the pain ladder?
Paracetamol and NSAIDs
What is the normal recommended dose of paracetamol, and maximum dose per day?
1-2 tablets of 500mg, up to 4 times a day. So the max dose per day is 4 grams.
If a patient weights less than 50kg, what is the advice with regards to paracetamol doses?
Half the recommended dose, so maximum 2 grams per day.
What is the recommended dose of ibuprofen and the maximum dose per day?
200-400mg, 3-4 times a day (this can be increased up to 600mg QDS) - maximum dose = 2.4 grams
When are NSAIDs contraindicated? (3)
In anyone with:
- Active bleeding, particularly intra-cranial or gastrointestinal
- Previous history of GI bleeding from NSAIDs
- Severe heart failure or uncontrolled hypertension
When should NSAIDs be used with caution? (3)
- Heart failure, cardiac arrhythmias, ischaemic heart disease
- Crohn’s disease
- Renal failure
What are the side effects of systemic NSAIDs? (2)
- GI bleeding
2. Exacerbation of Crohn’s - diarrhoea, dizziness
What are the signs/symptoms of an ibuprofen overdose? (4)
- Nausea
- Vomiting
- Epigastric pain
- Tinnitus
If someone with hepatic impairment takes ibuprofen, what are more at risk of? (2)
- GI bleeding
2. Fluid retention
In someone with renal impairment, what is advised if they are taking NSAIDs?
Take the lowest possible dose, for as short a time as possible
What must be monitoring if someone is taking NSAIDs with renal impairment?
Monitor their renal function, including sodium and water retention, and it can cause renal failure
What is step 2 on the WHO pain ladder?
Codeine or co-codamol
Tramadol
What is step 3 on the pain ladder?
Morphine and variations of
