Pain ladder

Question 1

neuropathic pain symptoms

Answer 1

back pain, shooting pain, radiating from back to legs, numbness, tingling

Question 2

1. ? for neuropathic pain

Answer 2

amitriptyline

Question 3

what type of drug is amitriptyline

Answer 3

amitriptyline is an anticholinergic medication. It inhibits the parasympathetic muscarinic receptors

Question 4

side effects of amitriptyline

Answer 4

A - anorexia 
B - blurred vision 
C - constipation and confusion
D - dry mouth and dry eyes 
S - sedation 

Can also cause long QT syndrome and postural hypotension

Question 5

when to avoid amitriptyline

Answer 5

elderly
glaucoma
dementia
PMH cardiac problems (primarily in relation to BP)

Question 6

2.? for neuropathic pain

Answer 6

gabapentin

Question 7

3.? neuropathic pain

Answer 7

pregabalin or duloxetine

Question 8

when to consider a lidocaine patch for neuropathic pain

Answer 8

lidocaine patches are considered when a patient is experiencing localised neuropathic pain. This is most commonly seen in post-herpetic neuropathy.

Question 9

nitrofurantoin if prescribed long term can result in?

Answer 9

pulmonary fibrosis

Question 10

morphine most common side effect

Answer 10

constipation

consequently, it is commonly prescribed in conjunction with laxido

Question 11

ACE inhibitors (e.g. lisinopril) common side effect

Answer 11

dry cough

Question 12

rifampicin can cause what side effect

Answer 12

red urine

Question 13

NSAIDs (e.g. naproxen) should be avoided in patients with a PMH of ?

Answer 13

asthma/gastric problems

Question 14

first line for non-nociceptive related pain management

Answer 14

paracetamol

Question 15

when to consider IV paracetamol

Answer 15

post-op pain or fever and pain

Question 16

2.? to paracetamol

Answer 16

codeine (+/- paracetamol = co-codamol)

Question 17

if a patient begins to suffer from constipation following codeine administration, what should you offer?

Answer 17

tramadol however may result in convulsions