Analgesia

Question 1

Paracetamol prescription Max Dose ? [2 Marks]

Answer 1

1g QDS (4g/day) (4x Daily)

500mg QDS (2g/day) 
- Weight <50kg or Liver dysfunction

Question 2

Ibuprofen prescription Max Dose?

Answer 2

400mg TDS (3x Daily)

Question 3

Naproxen prescription max dose?

Answer 3

250mg QDS

Avoid in renal impairment, GI Bleed/ulcer, Asthma

Question 4

Explain Analgesic ladder?

Answer 4

Step 1 - Mild Pain [Non-opioid]
Paracetamol / Aspirin / Ibuprofen +/- Adjuvant

Step 2 - Mild to moderate pain [Weak opioid]
Codeine +/- Non Opioid +/- Adjuvant
e.g Dihyrdocodeine, tramadol

Step 3 - Moderate to severe pain [Strong opioid]
Morphine +/- Non Opioid +/- Adjuvant
e.g oxycodone, methadone, fentanyl

Question 5

Common side effects of opioids?

Answer 5

Itch
Nausea
Constipation
Drowsiness

Question 6

What is breakthrough dose?

Answer 6

Additional PRN doses on top of regular opioids to help manage pain.

Question 7

Morphine to oxycodone?

10mg oromorph to oxy?

Answer 7

Divide by 2

e.g. 10mg oramorph = 5mg oxycodone

Question 8

Daily dose of morphine calculation from total dosage.

e.g. 15mg morphine QDS

Answer 8

Divide by 6

60mg daily = 60/6 = 10mg Morphine PRN

Question 9

Renal impairment: MORPHINE VS OXYCODONE

CHOOSE 1 and why?

Answer 9

OXYCODONE

Morphine is heavily renal excreted.