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Year 6 > Pain > Flashcards

Pain Flashcards

1
Q

Types of pain

A

Acute
Chronic

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2
Q

How can you treat bone pain

A

Non-medications:
Behaviour modifications, movement aids, home adaptations

Bisphosphonates
Strong opiods
Radiotherapy (most effective specific
treatment for cancer induced bone pain)

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3
Q

Radiotherapy helps what percentage of patients with cancer induced bone pain?

A

60 percent
Maximum effect at 6 weeks

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4
Q

WHO Analgesic Ladder

A

Step 1 - non-opioid
Step 2 - weak opioid + non-opioid

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5
Q

Examples of step 2 opioids

A

Codeine, dihydrocodeine
Tramadol
Buprenophine (but can become step 3 at higher doses)

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6
Q

Examples of step 3 opiods

A

Morphine
Alfentanil

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7
Q

Codeine to morphine enzyme for conversion

A

Cytochrome P450 CYP 2D6

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8
Q

Codeine vs morphine equation

A

Oral codeine is 10 times less potent than oral morphine

e.e. codeine 240mg = 24mg of morphine

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9
Q

Weak opiods + non opiod examples

A

Co-codamol

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10
Q
A

Usually patients are on moderate release prep

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11
Q

When might you get drowsiness as a side effect of pain medication

A

Drowsiness at initiation, dose increases or reductions

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12
Q

Other SE of opioids and how you can manage it

A

Constipation - prescribe a laxative

Nausea - usually self resolves with anti emetic, doesn’t come back

Drowsiness - lower the dose

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13
Q

Opioid toxicity side effects

A

Sedation
Confusion
Hallucinations
Myoclonic jerks
Pinpoint pupils
Coma

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14
Q
A
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14
Q
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15
Q

Would we use IV opioids? If not what’s the alterative?

A

Syringe drivers / continuous SC infusion rather than IV

16
Q

How potent is subcut morphine in comparison to oral morphine?

A

Subcut morphine is twice as potent as oral morphine

17
Q

If EGFR is less than 60, what would you give

A

Oxycodone

18
Q

Oral oxycodone is twice as strong as oral morphine

A
19
Q
A

Fentanyl
Butrans patch

Reduce dose or swich

Year 6 (2 decks)

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