Pain and Analgesics Flashcards
What is the definition of chronic pain?
Pain that persists more than 12 weels
What is a common co-morbidity of chronic pain?
Depression
Which analgesic should be avoided in pain in sickle-cell disease?
Pethidine because accumulation of neurotoxic metabolite can precipitate seizures
Which analgesic does naloxone only partially reverse?
Buprenorphine
Which analgesic has greater solubility and so allowed effective doses to be injected in smaller volumes?
Diamorphine hydrochloride (heroin)
What is the maximum number of times methadone can be administered per day?
twice to avoid risk of accumulation
What is recommended for postherpetic neuralgia?
Capsaicin
What is recommended for trigeminal neuralgia?
Carbamazepine - reduces frequency and severity of attachs
What is the treatment for precipitated withdrawal with buprenorphine?
Lofexidine if symptoms are severe
How do you reduce the risk of precipitated withdrawal?
first dose of buprenorphine should be given when patient is exhibiting signs of withdrawal or 6-12 hours after last use of heroin or 24-48 hours after last dose of methadone
When is methadone initiated?
at least 8 hours after last heroin dose
When is methadone and buprenorphine withdrawal preferable in pregnancy?
during second trimester with dose reductions made every 3-5 days
- first trimester poses a risk of spontaneous miscarriage
- third trimester not recommended because of maternal withdrawal
What are the symptoms of neonatal withdrawal?
High-pitched cry
Rapid breathing
Hungry but ineffective suckling
Excessive wakefulness
Severe but rare symptoms include - hypertonicity and convulsions
What is the contraindication of tramadol?
Uncontrolled epilsepsy
