Pain Flashcards
How long must pain be present for to be class as chronic pain?
12 weeks
Non-drug treatment of pain
Exercise, Transcutaneous electrical nerve stimulation, pain management programes (CBT)
Examples of non opioid analgesics
Paracetamol, NSAIDS, topical applications (capsaicin / lidocaine), Rubefacients
Above what dose of opioids should pain specialist advice be sought?
> 90mg/day morphine or equivalent
Which analgesic class is best suited for musculoskeltal pain?
Non-opioids e.g. paracetamol, NSAIDS and aspirin
Which analgesic class is best suited for visceral pain?
opioid analgesia
For dental pain e.g. plpitis jow long should analgesia be used for?
Max of 7 days - provides a temporary measure until the source is treated
What medication can be used to treat pain of the oral mucosa e.g. acute herpetic gingivotomastis?
Benzydamine hydrochloride mouthwahs/ spray
Which analgesic has antipyretic and pain relief effects but not anti-inflammation?
Paracetamol
Are opioids effective in dental pain?
No
What types of pain is aspirin indicated for?
headache, transient musculoskeletal pain, dysmenorrhea, pyrexia
When should aspirin be taken?
After food
What class of analgesia is useful to help with secondary bone tumours?
NSAIDS
bone tumours produce lysis of bones and release prostagladins
An example of an non-opioid intrathecal analgesic used for chronic severe pain
Ziconotide
Opiod side effects
Constipations, drowsiness, nausea, vommiting, respiratory depression, dependence
Which analgesic has both opioid agonist and antagonist properties
Buprenorphine
How long can buprenorphine sublingual last?
6 to 8 hours
Can naloxone fully reverse the effects of Buprenorphine?
No - only partially reverse the effects
Diamorphine causes less nausea and hypotension thta what other analgesic?
Morphine
how often must a fentanyl patch be changed?
every 72 hours
What is a benefit of Methadone over morphine
less seadating (and long half life)
What is the maximum frequency methadone can be given?
BD
what is the medication used as analgesia in labour?
Pethidine
how does Tapentadol produce analgesia?
- opioid effect
2. NA reuptaking inhibtion
How does Tramadol produce an analgesic effect?
opiod effect and enhancement of serotonergic and adrenergic pathways
What is Meptazinol?
A weak opioid - onest of 15 mins and duration of 2-7 hours
Side effects of opioids given via Epidural
pruritus, urinary retention, nausea & vomiting
If a patient has heptotoxicity risk factors what is the dose of IV paracetamol?
up to 50kg: 15mg/kg
>60kg 1g 4 to 6 hourly (max 3g) `
Paracetamol dosing for a 3 - 5 month year old
60mg 4 to 6 hourly (2.5mL of 120mg/5mL)
Paracetamol dosing for a 6-23 month year old
120mg 4 to 6 hourly 4 to 6 hourly (5mL of 120mg/5mL)
Paracetamol dosing for a 2 - 3 year old
180mg 4 to 6 hourly (7.5mL of 120mg/5mL)
Paracetamol dosing for a 4-5 year old
240mg 4 to 6 hourly (10mL of 120mg/5mL)
Paracetamol dosing for a 6-7 year old
240-250mg 4 to 6 hourly
Paracetamol dosing for a 8-9 year old
360-375mg 4 to 6 hourly (15mL of 120mg/5mL)
Paracetamol dosing for a 10 to 11 year old
480-500mg 4 to 6 hourly
Paracetamol dosing for a 12 - 15 year old
480-750mg 4 to 6 hourly
Paracetamol dosing for a 1 - 2 month year old
30-60mg 8 hourly