Symptoms of Pharmacy - Pain

Question 1

What is pain

Answer 1

seonsory and emotional response

Question 2

analestic

Answer 2

paracetamol, NSAID, codeine/dihydrocoeine

Question 3

paracetamol

Answer 3

reduces the production of prostaglandins in brain and spinal cord

child - suspension
soluble tablets - joint to a slat (Na - max 2g) / 3 paracetamol would be 3.5g excessive amount

safe in pregnancy and breastfeeding

dose - depends on age bands

Question 4

forms of paracetamol

Answer 4

medinol
disprol

Question 5

paracetamol suspension

Answer 5

suitable for children
from 2 months for post immunisation for post-immunisation pyrexia
3 months for fever and pain
shake bottle before use - drug will sink to bottom

Question 6

uses for paracetamol

Answer 6

migraine
headache

Question 7

caution of paracetamol

Answer 7

people w liver and kidney dysfunction
those taking warfarin - inc risk of bleeding
overdose - nausea and vomiting (after 4-6 days)

Question 8

NSAID

Answer 8

anti-inflammatory medication

Question 9

NSAID mechanism of action

Answer 9

inhibit porostaglandin (gg) synthesis by reversibly inhibiting cyclo-oxygenase

COX-1 procedures PH help to maintain gastroc mucosal integrity and platelet-initated blood clotting

COX-2 produces PG that medicate pain and inflammation

Question 10

NSAIDs may not be suitable for

Answer 10

asthma
kidney impairment
CV disease
Inflammatory bowel disease and Crohn’s disease and Ulcerative colitis
Lupus - ^^ risk of a-septic meningitis

Question 11

Contraindications of NSAIDs

Answer 11

• hypersensitivifty
• active peptic ulceration or gastro intestinal bleeding
• severe heart, renel or liver failure
• pregnancy
• breastfeeding - aspirin contraindicated

Question 12

Ibuprofen dose?

Answer 12

100mg/5ml suspension

Question 13

Naproxen - for what?

Answer 13

for period pain and menstrual cramps

take with food do not want to upset stomach

Question 14

aspirin (acetylsalicylic acid)

Answer 14

for mild to moderate pain in adults and children over 16

Question 15

Uses os aspirin

Answer 15

fever
headache
migraine

Question 16

Codeine/ Dihydrocodeine

Answer 16

adults + children over 12 yrs of age
OTC - co-codamol 8mg/500mg = paracetamol 500mg + 8mg codeine

Question 17

Codeine

Answer 17

activates and binds to Mu opioid receptors in the brain and spinal cord (CNS)

metabolized by liver enxymes (CYP2D6) into morphine

Genetic variability in metabolism

Question 18

Codeine uses?

Answer 18

acute moderate pain
(acute - lasts less than 3 months)

Question 19

side-effects of codeine

Answer 19

constipation
nausea
drowsiness

CAN be used in pregnancy but not OTC - refer to GP

Question 20

Dihydrocodeine

Answer 20

semi-synthetic opoid analgesic prescribed for pain or severe dyspnea

Question 21

Other active ingredients of Dihydrocodeine?

Answer 21

antihistamines - act as muscle relaxants can help with sleep e.g. dipenhydramine, doxylamine

Question 22

When to refer to GP with strains

Answer 22

fracture or dislocation
numbness
sever pain or movement
symptoms that have not improved after 48hrs
persistent pain even at rest

Question 23

treatment for strains

Answer 23

PRICE:

protection
rest
ice
compression
elevation

Question 24

treatments for strains

Answer 24

deep freeze
deep heat = sooth

Question 25

back pain factors

Answer 25

fitness levels
weight
mental health
job related activities
smoking

Question 26

sciatica

Answer 26

irritation or compression

Question 27

Management

Answer 27

keep moving
analgesics unlikley to erdicate pain but reduce volume of pain

Question 28

red flags for back pain:

Answer 28

major trauma
minor trauma - elderly
age of under 20 or over 50
unexplained weight loss
chills
pain worsening at night or lying down - cancer (spine)
severe progressive change in bowel or bladder function = a lot of nerves at bottom of spine / infection = REFER straight away for decompression surgery

Question 29

Oesteoarthritis

Answer 29

affects knees, joints

need to move

Paracetamol / NSAID 1st line

NOT NSAID and topical at same time - ^^ s/e

healthy weight management

Question 30

Tension headache

Answer 30

all ages/ all sexes
compression of head

Question 31

Tension headache causes

Answer 31

stress
anxiety
eye strain tiredness
posture

Question 32

Sinus headache

Answer 32

build-up of pressure in sinuses

Question 33

Medication overuse headache hard to unpick

Answer 33

caused by over use of pain medication

diagnose; stop meds for 1 months and then assess
NSAID and paracetamol, intake must be 15 days or more per months

Question 34

Migraine

Answer 34

severe headache, associated with other symptoms; nausea, vomiting sensitive to light/sound/smell

related to serotonin levels in brain

Question 35

1) migraine with an aura

Answer 35

with a visual disturbances

-light
-tingling in hand

Question 36

2) migraine without an aura

Answer 36

nausea and vomiting

Question 37

whats useful for migraine patients

Answer 37

a migraine diary

Question 38

treatments options for migraines

Answer 38

paracetamol, aspirin

Question 39

Contra-indications of migraines

Question 40

Meningitis

Answer 40

caused bhy bacteria and viruses
- in babies and toddlers = fever/cold hand and feet
- rapid breathing
- pale/ blochy skin - rash
-drowsy
- stiff neck
- tense bulging
- seizures

children and adults
- fever
- vomiting
- stiff neck
- cold hands and feet
- seizures
- pale/blochy skin - rash

Question 41

Responding to symptoms:

Answer 41

WWHAM
ENCORE
ASMETHOD
SITDOWNSIR