Pain Killas

Question 1

Risks with nsaids

Answer 1

Gi bleed- coffee ground vomit/ Black poo-> iron deficiency anaemia
Unintentional weight loss/ dysphagia
Swollen feet and ankles
Dyspepsia
Worsening asthma

Question 2

What do you want to check with nsaids

Answer 2

BP, renal function

Question 3

Interactions of nsaids

Answer 3

Quinolones- increased risk of convulsions
Warfarin nd antiplatelets- more anticoagulant effect
Nephrotoxicty with diuretics
Reduces excretion of methotrexate and lithium
Enhances effect of sulfonylureas

Question 4

When would you switch opioid to fentanyl patch

Answer 4

• constipation or renal function is becoming issue

Question 5

When would you switch opioid to fentanyl patch

Answer 5

• constipation or renal function is becoming issue

Question 6

When would you switch opioid to fentanyl patch

Answer 6

• constipation or renal function is becoming issue

Question 7

When are patches not suitable

Answer 7

Acute/ rapidly changing pain

Question 8

Primary route of excretion for opiods

Answer 8

Renal- renal impairment = opioid toxicity

Question 9

Breakthrough vs chronic dose of opiods

Answer 9

1/10th to 1/6th of 24 hourly dose every 2-4 hours

Question 10

Toxicity of opiods

Answer 10

Cog failure, allodynia, myoclonus, hallucinations, -> oxycodone or methodone