Session 9 - osteo Flashcards
What is involved in the non pharmacological management of OA?
educate LOSE WEIGHT increase activity - swimming can be helpful as less weight bearing physio knee braces/supports hot/cold packs shock absorbing soles in shoes walking aids
what is involved in the pharmacological management of OA?
pain management: topical/oral NSAIDs paracetamol capsaicin cream opioids- last resort
When would you consider surgery for an OA patient?
last resort-
if the pain is waking them up at night time often and is interfering significantly with their ADLs
AND have tried all other forms of treatment
AND aren’t too young or too old and are healthy enough to have the surgery (i.e. cardio/resp comorbidities)
what is pain?
an unpleasant sensory or emotional experience associated with actual or potential tissue damage
chronic pain is?
pain still felt after 3 months despite appropriate treatment
describe the steps in the analgesic ladder briefly
step 1: non-opiod analgesics- NSAIDs, paracetamol
step 2: mild opioids- codeine
cocodamol (paracetamol combined with opiates makes them work better)
step 3: strong opioids- morphine, tramadol, fentanyl, methadone
what is neuropathic pain?
pain that is associated with nerve damage, dysfunction or injury
what medications are better for treatment of neuropathic pain?
amytriptiline (tricyclic antidepressant)
gabapentin (also antiepileptic)
pregabilin (also antiepileptic)
what is breakthrough pain?
sudden flare of pain that is felt even through the long acting medication
you take PRN (pro re nata) medication for it, which means as and when needed
what are the side effects of NSAIDs?
exacerbate asthma
heartburn/indegestion: GORD
peptic ulcers (can give PPI with it)
bleed more (aspirin)
headaches, dizziness, drowsiness
side effect of codeine and what does this mean for its use
constipation - therefore can’t be tolerated long term
also dizziness, drowsiness
side effects of morphine/ tramadol
constipation, dizzy, drowsy, low BP, sweating, nausea
