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CNS > Pain > Flashcards

Pain Flashcards

1
Q

What is acute pain

A

Less than 12 weeks

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2
Q

What is chronic pain

A

More than 12 weeks

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3
Q

What is a non drug treatment for pain

A

TENS

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4
Q

What are some adjuvant therapies for pain

A

Antidepressants, benzos and muscle relaxants

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5
Q

What is given in musculoskeletal pain

A

Paracetamol, aspirin and NSAIDs

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6
Q

What is given in sickle cell pain

A

Mild - paracetamol, NSAIDs, codeine

Severe crisis - morphine

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7
Q

What does pethidine cause

A

Seizures - so avoid this

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8
Q

What is given in dental/orofacial pain

A

benzyldamine mouthwash, paracetamol, NSAIDs

Opioids hardly ever required

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9
Q

What is given in period pain

A

Paracetamol, NSAIDs. Can give antiemetic as well if need be

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10
Q

When are NSAIDS given

A

Pain and inflammation

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11
Q

How should you avoid the gastric issues with NSAIDs

A

Give after foodD

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12
Q

Does paracetamol have any anti-inflammatory activity

A

No

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13
Q

When is nefopam used

A

May be useful in persistent pain that is unresponsive to other analgesics. It can have antimuscarinic effects which can be troublesome

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14
Q

What is caffeine

A

Weak stimulant

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15
Q

Is co-proxamol still licensed

A

No - toxic

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16
Q

What is given in post operative analgesia

A

Morphine

17
Q

What is given for neuropathic pain

A

Amitriptyline, Nortriptyline, Gabapentin and Tramadol

18
Q

Can capsaicin cream cause burning

A

Yes it can

19
Q

Are NSAIDs effective in migraines

A

Yes

20
Q

What else are given in migraines apart from NSAIDs

A

Triptans (5HT1 receptor agonists)

Sumatriptan - first choice

21
Q

What if there is failed monotherapy with sumatriptan?

A

Sumatriptan+ naproxen

22
Q

What 2 drugs can be given for headaches

A

Metoclopramide and promethazine

23
Q

What is the pain ladder

A

1 - Non opioid (aspirin, paracetamol, NSAID)

2- Weak opioid (Codeine, dihydrocodeine, meptazinol)

3 - Strong opioid ( morphine, buprenorphine, diamorphine, fentanyl, oxycodone, tramadol)

24
Q

What are some main cautions with opioids?

A

Respiratory depression

Bradycardia

Sleepiness

Reduced concentration

Cyanosis

Vivid dreams, hallucinations

Convulsions

Pinpoint pupils

25
Q

What are some withdrawal signs with dependence on opioids

A

Sweating, tremor, D, N+V

26
Q

Can tolerance occur with opioids?

A

Yes they can - after long term treatment

27
Q

Opioids and alcohol

A

Sedation and hypotension

28
Q

Tramadol and coumarins

A

Increased anticoagulation effect

29
Q

Rifampicin and fentanyl/morphine/codeine/methadone/alfentanil

A

Reduced effects of fentanyl

30
Q

What can happen when opioids are given with MAOIs

A

CNS excitation/depression

31
Q

What is the opioid of choice in palliative care

A

Morphine

32
Q

What has both agonist and antagonist properties?

A

Buprenorphine - has abuse potential too

33
Q

What drug is partially reversed by naloxone

A

Buprenorphine

34
Q

What is less sedating - methadone or morphine

A

Methadone - longer duration of action

35
Q

Is oxycodone similar to morphine?

A

Yes - used when Morphine is not tolerated

36
Q

Is codeine a weak opioid?

A

Yes

37
Q

How can codeine be converted into morphine?

A

Hepatic codeine metabolism produces morphine and this capacity to metabolise codeine varies

38
Q

What is the contraindications of codeine?

A

Under 12

Ultra rapid metabolisers

Breastfeeding

Children with respiratory problems

39
Q

What should you monitor in fentanyl

A

Fever

Risk of respiratory depression

Remove if breathing issues, drowsiness, confusion and impaired speech

CNS (15 decks)

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