Pain Management

Question 1

Briefly describe the pain ladder

Answer 1

The pain ladder is a method used to select appropriate analgesics, starting from the least to most potent analgesic:
- Paracetamol
- NSAIDs
- Weak opioids: Codeine, Tramadol
- Strong Opioids: pethidine, fentanyl, morphine &laquo_space;oxycodone

Question 2

Which are the COX-2 selective inhibitors and what are the advantages and disadvantages associated with their use?

Answer 2

Celecoxib (Celebrex)
Etoricoxib (Arcoxia)

+: less GI SEs compared to less selective NSAIDs e.g ibuprofen, naproxen

-: may have more CV effects