Symptoms of Pharmacy - Pain Flashcards
What is pain
seonsory and emotional response
analestic
paracetamol, NSAID, codeine/dihydrocoeine
paracetamol
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
forms of paracetamol
medinol
disprol
paracetamol suspension
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
uses for paracetamol
migraine
headache
caution of paracetamol
people w liver and kidney dysfunction
those taking warfarin - inc risk of bleeding
overdose - nausea and vomiting (after 4-6 days)
NSAID
anti-inflammatory medication
NSAID mechanism of action
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
NSAIDs may not be suitable for
asthma
kidney impairment
CV disease
Inflammatory bowel disease and Crohn’s disease and Ulcerative colitis
Lupus - ^^ risk of a-septic meningitis
Contraindications of NSAIDs
- hypersensitivifty
- active peptic ulceration or gastro intestinal bleeding
- severe heart, renel or liver failure
- pregnancy
- breastfeeding - aspirin contraindicated
Ibuprofen dose?
100mg/5ml suspension
Naproxen - for what?
for period pain and menstrual cramps
take with food do not want to upset stomach
aspirin (acetylsalicylic acid)
for mild to moderate pain in adults and children over 16
Uses os aspirin
fever
headache
migraine
Codeine/ Dihydrocodeine
adults + children over 12 yrs of age
OTC - co-codamol 8mg/500mg = paracetamol 500mg + 8mg codeine
Codeine
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
Codeine uses?
acute moderate pain
(acute - lasts less than 3 months)
side-effects of codeine
constipation
nausea
drowsiness
CAN be used in pregnancy but not OTC - refer to GP
Dihydrocodeine
semi-synthetic opoid analgesic prescribed for pain or severe dyspnea
Other active ingredients of Dihydrocodeine?
antihistamines - act as muscle relaxants can help with sleep e.g. dipenhydramine, doxylamine
When to refer to GP with strains
fracture or dislocation
numbness
sever pain or movement
symptoms that have not improved after 48hrs
persistent pain even at rest
treatment for strains
PRICE:
protection
rest
ice
compression
elevation
treatments for strains
deep freeze
deep heat = sooth
back pain factors
fitness levels
weight
mental health
job related activities
smoking
sciatica
irritation or compression
Management
keep moving
analgesics unlikley to erdicate pain but reduce volume of pain
red flags for back pain:
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
Oesteoarthritis
affects knees, joints
need to move
Paracetamol / NSAID 1st line
NOT NSAID and topical at same time - ^^ s/e
healthy weight management
Tension headache
all ages/ all sexes
compression of head
Tension headache causes
stress
anxiety
eye strain tiredness
posture
Sinus headache
build-up of pressure in sinuses
Medication overuse headache hard to unpick
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
Migraine
severe headache, associated with other symptoms; nausea, vomiting sensitive to light/sound/smell
related to serotonin levels in brain
1) migraine with an aura
with a visual disturbances
-light
-tingling in hand
2) migraine without an aura
nausea and vomiting
whats useful for migraine patients
a migraine diary
treatments options for migraines
paracetamol, aspirin
Contra-indications of migraines
Meningitis
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
Responding to symptoms:
WWHAM
ENCORE
ASMETHOD
SITDOWNSIR
