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Year 4 Placements > Pain > Flashcards

Pain Flashcards

1
Q

What is the max dosage of paracetamol in 24 hours?

A

4 grams

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2
Q

Which liver marker can be used to assess liver damage in paracetamol overdose?

A

ALT

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3
Q

Which anticoagulant medication can interact with paracetamol?

A

Warfarin

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4
Q

Which antidote is given for paracetamol poisoning? This is infused over how long?

A

Acetylcysteine over 1 hour

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5
Q

Acetylcysteine should be commenced in patients presenting 8-24 hours after paracetamol ingestion who have taken how much mg/kg?

A

Over 150mg/kg

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6
Q

King’s College criteria for paracetamol induced liver failure states that pH of below what is indicative of liver transplant?

A

7.3

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7
Q

State the following Kings College criteria for paracetamol induced liver failure transplant:
1. Prothrombin time
2. Creatinine
3. Grade of encephalopathy

A
  1. PT over 100 seconds
  2. Creatinine over 300
  3. Grade III or IV encephalopathy
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8
Q

PPIs should be co-prescribed with NSAIDs in patients over what age?

A

45

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9
Q

What is the first line class of analgesia in back pain?

A

NSAIDs

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10
Q

Oligohydramnios and constriction of the ductus arteriosus are foetal side effects which may occur when prescribing which class of analgesics from week 20 of pregnancy?

A

NSAIDs

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11
Q

Which NSAID is contraindicated in ischaemic heart disease, peripheral arterial disease and congestive heart failure?

A

Diclofenac

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12
Q

What is the max dose of ibuprofen per day?

A

2.4g

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13
Q

Tramadol has a dual action of what?

A

Weak opioid plus serotonin and noradrenaline reuptake inhibitor

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14
Q

Which weak opioid lowers seizure threshold?

A

Tramadol

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15
Q

Which weak opioid can be utilised in neuropathic pain?

A

Tramadol

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16
Q

State the effect of opioids on:
1. Respiratory rate
2. Pupils
3. Gastric motility
4. Bronchus

A
  1. Depresses respiration
  2. Constricts pupils
  3. Reduces gastric motility
  4. Bronchoconstriction
17
Q

What is the most common side effect of opioids?

A

Constipation

18
Q

State the calculation for converting oral morphine dose to:
1. Subcutaneous
2. IV

A
  1. Half
  2. Third
19
Q

How is opioid overdose managed?

A

IV or IM naloxone

20
Q

Morphine is metabolised by what organ?

A

Liver

21
Q

Fill in the blank:
Weak opioids are __% the potency of morphine

A

10%

22
Q

Fill in the blank:
Oxycodone is __ x the potency of morphine

A

1.5-2

23
Q

Fill in the blank:
Breakthrough dose of morphine is __ of daily morphine dose

A

1/6

24
Q

How many mg per day of morphine should we give to opioid naive patients in the first instance?

A

20-30mg

25
Q

Which strong opioid should be used in mild to moderate renal impairment?

A

Oxycodone

26
Q

Which 2 strong opioids can be used in severe renal impairment?

A

Fentanyl and buprenorphine

27
Q

If still requiring breakthrough medication regularly, by what percentage may we increase a strong opioid in palliative patients?

A

30-50%

28
Q

What is the first line treatment for headaches caused by cerebral metastases?

A

Dexamethasone

29
Q

What 2 treatments may be offered in those with bone pain due to metastases?

A

IV bisphosphonate infusion and/or radiotherapy

30
Q

Muscle spasm pain in palliative patients may be managed by what 2 medications?

A

Diazepam or baclofen

31
Q

Suspected spinal cord compression due to metastases can be managed by administering what medication?

A

Dexamethasone

32
Q

How many neuropathic painkillers can be concurrently taken?

A

One

33
Q

Which neuropathic pain killer is the safest to use in renal impairment?

A

Amitriptyline

34
Q

Which neuropathic painkiller is utilised in trigeminal neuralgia?

A

Carbamazepine

Year 4 Placements (11 decks)

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