Pain Flashcards
What’s chronic pain
Pain greater than 12weeks
Depression is a Common comorbidity with chronic pain. True or false?
True
What’s primary chronic pain
No clear underlying condition
WHO pain ladder
See photo
What drug is useful in musculoskeletal pain
Nsaids, aspirin and PCM
List drugs used in sickle cell disease
Paracetamol and Nsaids, codeine and dihydrocodeine
Drugs used in severe crisis in sickle cell disease
Morphine or diamorphine may be needed
Drugs to avoid in sickle cell disease
Pethidine because it can cause seizure
Dental pain and orofacial pain tx
NSAIDs ( Ibuprofen, Aspirin, Diclofenac) use pcm temporary
Benzydamine mouthwash/spray can be used
Diazepam a muscle relaxant and Anxiolytics used short term
Dysmenorrhoea tx
Antiemetic to prevent vomiting
Pcm and NSAID used to provide relief
Oral contraceptive can be used to prevent pain associated with ovulatory cycles
A non-opiod analgesic used to tx headache, musculoskeletal pain , dysmenorrhoea and pyrexia is ….
Aspirin
State what to do to prevent GI problems associated with aspirin
Take dose after food , enteric coated preps have slow onset of action and therefore unsuitable
Aspirin interacts with…
Other drugs especially warfarin which is a special hazard
What drug can be used for pain not responding to non opiod analgesic but has more side effects
Nefopam
Indication of NSAID
Chronic disease accompanied by pain and inflammation
Short tx of mild -moderate pain but PCM more preferable esp in elderly
Suitable for dysmenorrhoea
Pain caused by secondary bone tumour
Use for post operative analgesia
What drug is preferred over NSAIDs for patients with high risk of G.I side-effects
Cyclo-oxygenase 2
Facts about caffeine
It is a weak stimulant and enhances analgesic effect
Facts about Opiods analgesic
To relief moderate- severe pain of visceral origin
Repeated used may cause dependence and tolerance
Caution with opiod analgesic
Caution in impaired respiratory function, asthma, hypotension, MG, shock, convulsive disorder
Opiod analgesic should be avoided in…
COPD
Some opiod side effects
Respiratory depression- reversed by naloxone or artificial ventilation
Overdose can cause coma, Respiratory depression and pinpoint pupils
Other side effects of opoid
Constipation
Dry mouth
N and V
Biliary spasm
Drowsiness
LT use - hypogonadism and adrenal insufficiency
Larger doses- muscle rigidity, hypotension, Respiratory depression
Pt and carer advice for opoids
Drowsiness, may affect driving or skilled task
Facts about morphine as a strong opiod
Most valuable opiod analgesic for severe pain despite causing N and V
Confers euphoria and a state of detachment in addition to pain relief
Given every 4hrs
Every 12- 24hrs as MR prep
