Pain Management

Question 1

Behaviour and vital signs (blood pressure, pulse) are reliable indicators of pain. True/False?

Answer 1

False

Neither sensitive nor specific - self-reporting is much more reliable

Question 2

What is allodynia?

Answer 2

Pain from a stimulus that is not normally painful

Question 3

What is hyperalgesia?

Answer 3

Pain that is beyond what is expected from a painful stimulus

Question 4

Which drugs form the WHO ladder for treating pain?

Answer 4

Non-opiods: paracetamol, NSAIDs

Opiods: tramadol, codeine, morphine

Question 5

List some topical analgesics

Answer 5

Capsaicin

Lidocaine 5% plaster

Question 6

How do NSAIDs fight pain? Give examples of drugs and side effects

Answer 6

Inhibit COX1 to decrease prostaglandin synthesis
Aspirin, ibuprofen
GI irritation, renal toxicity

Question 7

How does paracetamol work? List a side effect

Answer 7

Inhibits prostaglandin synthesis

Risk of liver toxicity

Question 8

How do opioids work? Give examples of drugs and side effects

Answer 8

Affect descending pathways to reduce pain perception and transmission
Tramadol, codeine, morphine
Nausea, vomiting, constipation, dizziness

Question 9

Anti-depressants (amitriptyline) can be used for pain. How do they work? List some side effects

Answer 9

Inhibit noradrenaline and 5-HT uptake

Constipation, dry mouth, arrhythmias, insomnia