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Cancer Care > Pain > Flashcards

Pain Flashcards

1
Q

What is pain?

A

Abnormal stimulus that the patient says hurts

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2
Q

What are the main types of pain?

A

Nociceptive

  • somatic
  • visceral

Neuropathic

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3
Q

What is nociceptive pain?

A

Normal nervous system, identifiable lesion causing tissue damage

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4
Q

What is somatic pain?

A

Pain originates from skin/muscle/bone

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5
Q

What is visceral pain?

A

Pain originates from hollow viscus/solid organ

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6
Q

What is neuropathic pain?

A

Pain from a malfunctioning nervous system

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7
Q

How is neuropathic pain described?

A

Stabbing
Shooting
Burning

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8
Q

What can be used for neuropathic pain?

A

Amitriptyline 10-25 mg nocte
Gabapentin 300mg TDS
Pregabalin 75mg BD

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9
Q

What are side effects of neuropathic pain reliedf?

A

Sedation
Dizziness
Confusion
Renal impairment

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10
Q

What is the WHO ladder?

A

Step 1
- non-opioid +/- adjuvant

Step 2
- weak opioid +/- adjuvant

Step 3
- strong opioid +/- adjuvant

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11
Q

What are non-opioids?

A

Paracetamol

NSAIDs

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12
Q

What are weak opioids?

A

Codeine
Co-codamol
Dihydrocodeine
Tramadol

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13
Q

What are strong opioids?

A

Morphine
Oxycodone
Fentanyl

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14
Q

What are adjuvants?

A

Anti-depressants - amitriptyline
Anti-convulsants - gabapentin, pregabalin
Steroids
Bisphosphonates

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15
Q

What are the WHO principles of pain relief?

A 
By the mouth - give oral whenever possible
By the clock - give regularly
By the ladder
Individual dose titration 
Use adjuvants as necessary
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16
Q

What should you always prescribe with an NSAID/COX2 inhibitor?

A

PPI

17
Q

Which NSAID/COX2 inhibitor do you prescribe if there is no GI/CVS risk?

A

Naproxen

18
Q

Which NSAID/COX2 inhibitor do you prescrive if there is GI risk?

A

Celecoxib

19
Q

Which NSAID/COX2 inhibitor do you prescribe if there is CVS risk?

A

Naproxen

20
Q

What are the types of morphine available?

A

Immediate release = oramorph

Slow release = zomorph

21
Q

How is morphine dose calculated?

A

TDD = total daily requirement

SR = TDD/2

IR = TDD/6

22
Q

What are the side effects of morphine?

A

Constipation
Nausea
Sedation
Dry mouth

23
Q

What is a syringe driver

A

Subcutaneous morphine given over 24hrs

Still need PRNs

24
Q

What is the conversion between PO and SC morphine?

A

PO:SC
2:1

So half the dose when going oral to SC

25
Q

How long do fentanyl patches take to work?

A

24 hours

26
Q

How long are fentanyl patches left on for?

A

3 days

27
Q

What are signs of opioid toxicity?

A

Pinpoint pupil
Drowsiness
Sedation
Hallucinations

28
Q

What is key to check in someone with new opioid toxicity?

A

Renal function

Cancer Care (14 decks)

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