Pain Management Flashcards
Which type of pain is most commonly associated with damage, tumours or trauma to bones, muscles, etc..?
1 - neuropathic
2 - somatic
3 - visceral
2 - somatic
Visceral relates to internal organs and blood vessels (liver, gallbladder, etc.)
Neuropathic relates to nerve damage
Between visceral and somatic pain, which is well localised and which is vague?
Somatic = well localised
Visceral = vague
SOCRATES is what is used for a pain history
Which 2 drugs make up co-codamol?
1 - codeine and aspirin
2 - codeine and ibuprofen
3 - codeine and paracetamol
4 - codeine and naproxen
3 - codeine and paracetamol
Codeine is metabolised by the liver into morphine and morphine-6-glucuronide.
What sensation is the use of tramadol associated with?
1 - dysuria
2 - burning sensation in feet
3 - walking on cotton wool
4 - all of the above
3 - walking on cotton wool
Associated with peripheral neuropathy
Codeine and tramadol are on the 2nd step of the analgesia ladder and are weak opioids. Morphine is a stronger opioid than codeine PO, but by what factor?
1 - 2 x stronger
2 - 5 x stronger
3 - 10 x stronger
4 - 20 x stronger
3 - 10 x stronger
240mg of codeine = 24mg morphine
Which 2 of the following can only be given via transdermal patches?
1 - Fentanyl
2 - Alfentanil
3 - Buprenorphine
4 - Oxycodone
1 - Fentanyl
Replaced every 72h
3 - Buprenorphine
Replaced every 7 days
Typically take 24h before they begin to work
Alfentanil = injectable only
Oxycodone = various forms
In palliative care, which of the following medications should NOT used in patients with renal impairment in case of renal accumulation and damage?
1 - Fentanyl
2 - Alfentanil
3 - Buprenorphine
4 - Morphine
4 - Morphine
In palliative care, in patients with renal impairment the following medications can be used, but in an acute setting, which would be most effective?
1 - Fentanyl
2 - Alfentanil
3 - Buprenorphine
2 - Alfentanil
The other 2 are patches and take longer to take an effect
In palliative care, which 2 of the following medications should be used in patients with hepatic impairment?
1 - Fentanyl
2 - Alfentanil
3 - Buprenorphine
4 - Morphine
1 - Fentanyl
4 - Morphine
Of the 4 medications below, which one is best to use in a palliative patient who has renal and hepatic impairment?
1 - Fentanyl
2 - Alfentanil
3 - Buprenorphine
4 - Morphine
1 - Fentanyl
SC or IV if available
2nd choice would be Alfentanil
Which of the following medications is NOT classes as an NSAID?
1 - Aspirin
2 - Diclofenac
3 - Ibuprofen
4 - Naproxen
5 - Celecoxib
6 - Amitriptyline
6 - Amitriptyline
Tricyclics antidepressant
Celecoxib = COX-2 inhibitor
All others are non-selective NSAIDs
In palliative patients, cancer is the most common type of pathophysiology. Which of the following medications is given as an adjuvant to help combat the fluid accumulation and inflammation tumours can cause?
1 - amitriptyline
2 - sumatriptan
3 - dexamethasone
4 - naloxone
3 - dexamethasone
Given to reduce ICP in metastatic brain cancer
In palliative patients, cancer is the most common type of pathophysiology. Which of the following medications is given as an adjuvant to help combat neuropathic pain and are classed as anti-epileptic medication?
1 - Gabapentin
2 - Ondansetron
3 - Pregabalin
4 - Amitriptyline
1 - Gabapentin
3 - Pregabalin
Both of these drugs can lead to delirium
In palliative patients, cancer is the most common type of pathophysiology. Which of the following medications is given as an adjuvant to help combat neuropathic pain and are classed as Tricyclics antidepressant antidepressant medication?
1 - Gabapentin
2 - Ondansetron
3 - Pregabalin
4 - Amitriptyline
4 - Amitriptyline
Fatal in overdoses
In drugs morphine and oxycodone, the SC route provides a stronger dose than the oral route. How much stronger is the SC dose when compared to the oral dose?
1 - 20 times stronger
2 - 10 times stronger
3 - 5 times stronger
4 - 2 times stronger
4 - 2 times stronger
100mg oral morphine or oxycodone =
50mg SC morphine or oxycodone
SC oxycodone is also 4 times stronger than oral morphine, for example:
20mg PO Morphine is = 10mg SC Morphine
10mg PO Oxycodone = 5mg SC Oxycodone
20/4 = 5mg
What is the half life of morphine?
1 - 1h
2 - 4h
3 - 8h
4 - 16h
2 - 4h