Pain Flashcards
Is the following statement true or false? Good analgesia can result in bigger improvements in function then would be expected from changes in pain scores.
It’s true. Analgesia will result in an improvement in pain scores but the effects on peoples function can be much larger.
Is the following statement true or false? Neuropathic pain is common in older people.
It’s true. Neuropathic pain is very common in older people
Is the following statement true or false? Neuropathic pain is effectively treated using common analgesics like NSAIDs.
It’s false. NSAIDs are anti-inflammatory drugs. Neuropathic pain is caused by damage to nerves. Anti-inflammatories are likely to be of little use, and management of pain can be very difficult.
Is the following statement true or false? Neuropathic pain is caused by inflammation.
It’s false. Neuropathic pain is not caused by inflammation.
Is the following statement true or false? Older people are likely to be less stoic than younger people.
It’s false. Older people are likely to be more stoic than younger people meaning they are more likely to endure pain without complaint.
Is the following statement true or false? Older people are more likely to experience severe cancer pain than younger people.
It’s false. The severity of various types of pain is affected by age, but cancers appears to cause less severe pain in older people.
Is the following statement true or false? Opioids should never be used in older patients
It’s false. Opioids can be used in older people. For less severe pain weak opioids can be used in combination with other drugs, with stronger opioids reserved for more severe pain, and there is evidence to suggest that people with severe pain should start off on stronger drugs.
Is the following statement true or false? Aged people living in aged care facilities usually have better pain management than those who live in the community.
It’s false. Pain management for people in residential care facilities is often poor.
Is the following statement true or false? Allodynia is a sensation of pain in response to normally non-painful stimuli.
It’s true. Allodynia is central pain sensitization following normally non-painful, often repetitive, stimulation.
Is the following statement true or false? The development of leg and foot pain appears to continue until people reach very advanced ages.
It’s true. Let on foot pain appears to continue to develop well into the 9th decade of life.
What are the steps on the pain medication ladder?
- Least severe pain : NSAIDs and paracetamol.
- More severe pain, or pain that fails to respond to step 1: weak opioids alone or in combination with paracetamol.
- Severe pain: strong opioids .
- Use supporting/non-pharmacological treatments as much as possible.
What are the issues surrounding the use of each of the medications on the ladder?
- NSAIDs associated with an increased risk of gastric ulceration, renal damage and cardiovascular events
- Opioids are associated with a risk of tolerance (increasingly large doses needed to obtain the same effect) and dependence (inability to function normally without the drug). Also constipation, nausea, sedation
What is meant by “start low, go slow” in regard to analgesic medications?
In begin by using drugs lower on the pyramid at lower doses and move upwards slowly as required. However there is some evidence that people with severe pain may benefit by being initially treated with stronger drugs at higher doses.
