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Nervous System FT > Pain > Flashcards

Pain Flashcards

1
Q

First line for neuropathic pain

A

Amitriptyline and pregabalin (can be used in combination if patient has inadequate response to either drug at maximum tolerated dose).

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2
Q

What is the maximum dose of amitriptyline that can be prescribed? A. Amitriptyline 75mg
B. Amitriptyline 100mg
C. Amitriptyline 150mg
D. Amitriptyline 50mg

A

(A) in major depressive disorder Amitriptyline 150mg is max

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3
Q

Which agent is unlicenced in the use of neuropathic pain
A. Amitriptyline
B. Nortriptyline
C. Pregabalin
D. Morphine

A

B

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4
Q

Which one must be initiated by specialist for the use in neuropathic pain management
A. Amitriptyline
B. Nortriptyline
C. Pregabalin
D. Morphine
E. Oxycodone

A

D and E

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5
Q

What can be prescribed for neuropathic pain whilst the patient await an appointment with specialist.

A

**Tramadol **

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6
Q

Which strength of capsaicin can be licensed for neuropathic pain and postherpetic neuralgia?

A
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7
Q

What drug can be given IV in trigeminal neuralgia crisis?

A

A

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8
Q

What NSAIDs are commonly indicated in the pain relief of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis and gout ?

A
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9
Q

If there is knee involvement in osteoarthritis pain what agent is appropriate to prescribe?

A
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10
Q

What is first line for pain relief in osteoarthritis?

A
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11
Q

First line for pain management in Endometriosis (including duration)

A

Short trial of NSAIDs or paracetamol or in combination for 3 months.
Mefenamic acid may be considered here. //Diclofenac gel ibuprofen.

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12
Q

What analgesic is indicated for abdominal pain or discomfort if patient has not responded to antispasmodics, antimotility or laxatives?

A

Amitriptyline-unlicensed use.

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13
Q

Which agents should you NOT prescribe in the management of sciatica?

A

Do not offer gabapentinoids, other antiepileptics, oral corticosteroids or benzodiazepines for managing sciatica as there is no overall evidence of benefit and there is evidence of harm. [2020]

1.2.17. Do not offer opioids for managing chronic sciatica.

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14
Q

First line for lower back pain

A

NSAIDs. Do not offer opioids for managing chronic low back pain or gabapentinoids.

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15
Q

First line for diverticulitis

A

Often associated with inflammation of bowel causing pain and discomfort and rectal bleeding therefore NSAIDs are not appropriate choice.
First line: Paracetamol

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16
Q

Paroxysmal Hemicrania
What are the defining symptoms?
Are there any associated causes?

A

Attacks are more frequent than cluster headaches.
However response to Indomethacin.

17
Q

Cluster headaches
What are the defining symptoms?
Are there any associated causes?
Where is the headache located?
How long must the headache last for in episode?

A
18
Q

Tension Headache
What are the defining symptoms?
Are there any associated causes?
Where is the headache located?
How long must the headache last for in episode?

A
19
Q

Μigraine
What are the defining symptoms?
Are there any associated causes?
Where is the headache located?
How long must the headache last for in episode?

A
20
Q

What is classes as medication overuse headache and what medications are commonly observed here?

A

Triptans, opioids, ergot or combination analgesic medications on 10 days/month
Or
Paracetamol, aspirin or NSAID either alone or in combination, on 15 days per month or more.

21
Q

First line for acute treatment of cluster headaches

A

Note: do not recommend the use of paracetamol, nonsteroidal anti-inflamm

22
Q

First line for tension headache

A

Analgesia for mild to moderate pain are:
Paracetamol
NSAIDS
Aspirin

23
Q

First line and second line for acute migraine and then prophylaxis

A

Prophylaxis: Beta blocker-propranolol

24
Q

What is the licensing for Sumatriptan and dose for the said age group?

A

> 12 years (10 mg nasal spray of sumatriptan)

<not licensed for over 65 years.

25
Q

What would you give to migraine user is vomiting restricts their intake of medicine?

A

Melt preparation or intranasal spray of SC injection.

26
Q

What antiemetic is indicated in acute treatment of migraine?

A

Metoclopramide
Prochlorperazine.

27
Q

When are triptans inappropriate to prescribe?

A

Cardiovascular disorder
Cerebrovascular disorder
Severe hepatic impairment
MAO-I

28
Q

What are the adverse effects of Triptans?

A

NS: Drowsiness and dizziness
RS: Dyspnoea
GI: Nausea and vomiting
With intranasal use: epistaxis

29
Q

For breastfeeding ladies on sumatriptan how should they avoid the exposures to infant?
A. 4 hours
B. 6 hours
C. 12 hours
D. 3 hours

A

C

30
Q

What is the dose that should be considered in treatment of migraine associated with headache nausea or vomiting?
A. 10mg Prochlorperazine and Metoclopramide
B. 20 mg Prochlorperazine and 10 mg Metoclopramide
C. 30 mg Metoclopramide and 10 mg Prochlorperazine
D. 10 mg Metoclopramide and 20 mg Prochlorperazine

A

A.

31
Q

```

~~~

What is the licensing for Metoclopramide and Prochlorperazine?

A

Prochlorperazine: >12 years of age.
Metoclopramide: not licensed.

Nervous System FT (4 decks)

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