Pain relief

Question 1

What are the subsequent doses for all adults for Fentanyl?

Answer 1

50mcg (.25mls) followed by 25mcg (.2mls)

Question 2

What is the presentation for Fentanyl?

Answer 2

600mcg in 2mls for adults

100mcg in 2mls for children

Question 3

What is the dose for IN fentanyl in Paediatrics?

Answer 3

Large child (>25kgs) = 50mcg
Small child (

Question 4

What is the subsequent fentanyl dose for paediatrics?

Answer 4

Repeat initial dose @5min, titrating to pain

MAX 3 doses

Question 5

What is the max dose for fentanyl in adults?

Answer 5

For frail elderly and

Question 6

What are the contraindications for fentanyl?

Answer 6

IV amiodarone and hypersensitivity

Question 7

What are some side effects of fentanyl? (3)

Answer 7

Respiratory depression
Rigidity of the diaphragm and intercostals
Bradycardia

Question 8

What is the dose of IV fentanyl for adults?

Answer 8

25-50mcg, titrating to pain and effect.
Repeat initial @ 5min
Max 200mcg

Question 9

What is the dose of methoxyflurane?

Answer 9

3ml

Max 6ml in a 24 hour period

Question 10

What are the contraindication of Penthrane?

Answer 10

Renal impairment
Use of tetracycline antibiotics (for uti’s)
No more than 6ml in 24 hours

Question 11

Severe headache is characterised by a pain score of more than what?

Answer 11

> 7

Question 12

What 2 things should be considered when assessing severe headache?

Answer 12

Suspected cerebral bleed (stroke)

Or potential Meningeal infection (meningococcal)

Question 13

What are signs that can be suggestive of a serious intracranial event?

Answer 13

• Sudden onset or thunderclap of pain.
• Hx of cancer
• Altered level of consciousness
• Seizure activity
• Fever or neck stiffness

Question 14

What drug(s) should first be administered in severe headaches?

Answer 14

3ml of Methoxyflurane (repeat if necessary)

Stemitil 12.5mg IM prophylactically.

Question 15

In what case would stemitil offer no clinical benefit in regards to severe headaches?

Answer 15

In cases of intracranial haemorrhage

Question 16

If methoxyflurane is not effective in relieving severe headaches, what drug should next be administered?

Answer 16

Morphine IV or fentanyl IV

However, only after 15min of previous therapy, pt still in severe pain and hospital is >15min away 
If IV access unavailable: 
Elderly, frail or underweight= 50mcg IN
All other adults= 100mcg IN
        Repeat with 25mcg IN

Question 17

What is the initial dose of Fentanyl for an adult?

Answer 17

If elderly, frail or less than

Question 18

What are the paediatric dosages for Fentanyl?

Answer 18

Large child (>25kg)= 50mcg IN
Small child (

Question 19

What is the IM dose of Morphine for a paediatric patient?

Answer 19

0.1mg per kg

Single dose