Pain

Question 1

What are the red flags when talking about pain?

Answer 1

• Weight loss
• Saddle anaesthesia
• Sensory changes
• Fever
• Night pain
• Thoracic pain
• Sphincter disturbance

Question 2

Name some common types of pain

Answer 2

• Neuropathic (MS)
• Vascular (Peripheral artery disease, ulcers)
• Visceral (appendicitis)
• Pallative (cancer)
• Chronic widespread (fibromyalgia)
• MSK (FNOF)

Question 3

What pain relief should be prescribed to someone with moderate pain?

Answer 3

Codeine

NB - you can prescribe oromorph PRN for breakthrough pain (in case it gets much worse)

Question 4

What is the antidote to morphine?

Answer 4

Naloxone

Question 5

What are some common side effects of opioids?

Answer 5

• Constipation
• Confusion
• Dependence
• Pinprick pupils
• Dry mouth
• Nausea
• Itchiness

Signs of toxicity:

• Respiratory depression
• Cardiovascular depression
• Twitching

Question 6

What are some side effects of NSAIDS?

Answer 6

• Internal bleeding
• Nausea
• Diarrhoea
• Abdo pain

Question 7

What are some side effects of steroids?

Answer 7

• IMMUNOSUPPRESION
• DIABETES
• OSTEONECROSIS
• Central wasting
• Weight gain
• Buffalo hump
• Skin and hair thinning
• Amenorrhoea
• Cataracts and glaucoma
• Pancreatitis/peptic ulcer
• Impotence
• Proximal myopathy