Pain

Question 1

Simple analgesics

Answer 1

Paracetamol (acetaminophen)

Non-Steroidal Anti-inflammatory drugs
Diclofenac, Ibuprofen, Aspirin

Question 2

Opioids

Mild analgesics

Answer 2

Codeine

Dihydrocodeine

Question 3

Opioids

Strong analgesics

Answer 3

Morphine (chronic cancer)
Oxycodone
Fentanyl

Question 4

Tramadol

Answer 4

Mixed opiate and

5HT/NA reuptake inhibitor

(inhibitor of serotonin and noradrenaline reuptake)

Question 5

Antidepressants

Answer 5

amitriptyline

duloxetine

Question 6

Anticonvulsants use and examples

Answer 6

Carbamazepine (Tegretol)
Sodium valproate (Epilim)
Gabapentin (Neurontin)

For *neuropathic pain

Question 7

Topical agents

Answer 7

Capsaicin

Question 8

NMDA Receptor antagonist

Answer 8

Ketamine

SE: Increased Heart Rate, Hypertension, Hallucination

Question 9

Treatments - Periphery

Answer 9

Non-drug treatments
- Rest, ice, compression, elevation
NSAID’s (for Nociceptive pain)
Local anaesthetics

Question 10

Treatments - Spinal Cord

Answer 10

Non-drug treatments
- Acupuncture, massage, TENS
Local anaesthetics
Opioids
Ketamine

Question 11

Treatments - Brain

Answer 11

Non-drug treatments
- Psychological 
Drug treatments
- Paracetamol
- Opioids
- Amitriptyline
- Clonidine

Question 12

Clonidine Function + SE

Answer 12

a-2 adrenoreceptor agonist

high blood pressure 
ADHD
Drug withdrawal
menopausal flushing
diarrhoea

Question 13

Paracetamol SE

Answer 13

Liver damage in overdose

Question 14

Non-Steroidal Anti-Inflammatory Drugs Function SE

Answer 14

Gastrointestinal and renal
sensitive asthmatics

Synergistic effects with paracetamol

Question 15

Codeine SE

Answer 15

Constipation

Not good for chronic pain

Question 16

Tramadol SE

Answer 16

Nausea and vomiting

Question 17

Morphine SE

Answer 17

Constipation
Respiratory depression in high dose
Controlled drug

Question 18

Amitriptyline Function + SE

Answer 18

Tricyclic antidepressant (TCA)
Increases descending inhibitory signals

SE: Anti-cholinergic side effects (e.g. glaucoma, urinary retention)

Question 19

Pain Management

Answer 19

Recognise

Assess

• Severity? (cough, work, move)
• Type? acute, chronic, cancer, neuropathic
• Other factors? Anger, anxiety, depression

Treat

• Non-drug treatments
• Drug treatments

Question 20

neuropathic features

Answer 20

Burning or shooting pain
Phantom limb pain
Other features (pins and needles, numbness)

Question 21

Nociceptive Pain WHO pain Ladder

Answer 21

Mild
- Paracetamol (± NSAIDs)

Moderate
- Paracetamol (± NSAIDs) + codeine/ alternative

Severe
- Paracetamol (± NSAIDs) + morphine