Pain

Question 1

What is the suitable first line choice for treating mild to moderate pain in children under 16?

Answer 1

Paracetamol or ibuprofen should be used

Question 2

For adults and children aged over 16 years, what is step 1 of the ‘pain ladder’?

Answer 2

paracetamol should be used

Question 3

For adults and children aged over 16 years, what is step 2 of the ‘pain ladder’?

Answer 3

paracetamol should be substituted with ibuprofen or, if ibuprofen is unsuitable, a weak opioid (such as codeine).

Question 4

For adults and children aged over 16 years, what is step 3 of the ‘pain ladder’?

Answer 4

paracetamol should be added to ibuprofen or the weak opioid.

Question 5

For adults and children aged over 16 years, what is step 4 of the ‘pain ladder’?

Answer 5

paracetamol should be continued and ibuprofen replaced with an alternative NSAID.

Question 6

For adults and children aged over 16 years, what is step 5 of the ‘pain ladder’?

Answer 6

a weak opioid should be started in addition to paracetamol and/or a NSAID.

Question 7

What should be used before considering to switch to another analgesic?

Answer 7

A full therapeutic dose of one drug should be used before considering switching to a different analgesic or adding another analgesic.

Question 8

What should be avoided in first line treatment?

Answer 8

Combination analgesics should be avoided as first-line treatment. Prescribing single constituent analgesics allows independent titration of each drug.