analgesics Flashcards
(53 cards)
pain relief for mild sickle cell crisis (when blood vessels to part of the body become blocked)
paracetamol, NSAID, codeine, dihydrocodeine
pain relief for severe sickle cell crisis
morphine or diamorphine may be required
concomitant use of NSAID may potentiate analgesia and allow lower doses of opioid
pain relief for severe sickle cell crisis can comprise of morphine or diamorphine, concomitant use of NSAID can potentiate analgesia and allow for lower doses of opioid to be used. why should pethidine be avoided if possible? (2)
accumulation of neurotoxic metabolite can precipitate seizures
also relatively short half life means frequent injections
dental and orofacial pain - analgesics as a temporary measure until cause of pain has been dealt with. e.g. pain and discomfort associated with acute problems or oral mucosa (e.g. acute herpetic gingiostomatitis, erythema multiforma) can be relieved by … until cause of mucosal disorder has been dealt with
benzydamine mouthwash or spray
most dental pain is relieved effectively by this drug class
NSAIDs - ibuprofen, aspirin, diclofenac
is opooid needed for deltal pain
rarely required.
paracetamol, ibuprofen or aspirin are adequate for most cases
combining non opioid with opioid analgesic can provide greater relief of pain than either analgesic given alone, but only when an adequate dose of each analgesic is used
important thing to consider when giving analgesic before dental procedure
needs to have low risk of increasing post op bleeding
T or F - In the case of pain after dental procedure, taking an analgesic before the effect of the LA has worn off can improve control
true
post op dental procedure analgesia with ibuprofen or aspirin is usually continued for ?
24-72h
Temporomandibular dysfunction - what is it
This is a condition affecting movement of the jaw and can cause pain and stiffness around the jaw, ear and temple
Symptoms include pain around draw and clicking or grinding noise when moving jaw
Temporomandibular dysfunction may be related to
anxiety in some patients who may clench or grind their teeth during the day or night
Temporomandibular dysfunction - The muscle spasm (which appears to be the main source of pain) may be treated empirically with …..
and these may also be used ….
an overlay appliance which provides a free sliding occlusion and may also interfere with grinding
Diazepam which has muscle relaxant and anxiolytic properties may be helpful but should only be prescribed on short term basis during acute phase
Analgesics such as aspirin or ibuprofen may also be used
dysmenorrhea (period pain) - what can you take
Use of oral contraceptive prevents pain of dysmenorrhea which is generally associated with ovulatory cycles
Paracetamol or NSAID said will generally provide adequate relief for pain
Vomiting and severe pain associated with dysmenorrhea in women with endometriosis may require antiemetics in addition to analgesic
Antispasmodic such as alverine citrate have been advocated for dysmenorrhea but the antispasmodic action doesn’t generally provide significant relief
overdosage of paracetamol is dangerous because
can cause hepatic damage which is sometimes not apparent for 4-6 days
nefopam is a non opioid analgesic. when can it be used and what are the adv + disadvantages?
May have a place in the relief of persistent pain unresponsive to other non opioid analgesics
Causes little or no respiratory depression
However it has sympathomimetic (e.g. HTN, hyperthermia, tachycardia and anti muscarinic side effects
Interactions: MAOIs - severe HTN
what can you use in preference to non-selective NSAIDs for pt at high risk of developing serious GI SE?
cox-2 inhibitors
ziconotide and its use and its route of Amin
non opioid analgesic
Administered by intrathecal infusion
Licence for treatment of chronic severe pain
Can be used by hospital specialist as adjunct to opioid analgesics
use of caffeine in compound analgesic preparations
- weak stimulant
- often included in small doses in analgesic preps
- claimed that adding it may enhance analgesic effect
- however alerting effect, mild habit forming effect and possible provocation of headache may not always be desirable
- in excessive dosage or on withdrawal caffeine may induce headache
opioids are usually used to relieve moderate to severe pain, particularly of …. origin
visceral
Morphine is the standard against which other opioids are compared to. it is the opioid of choice for oral treatment of severe pain in palliative care. how often is it given?
regularly every 4 hours
or every 12 or 24 hours as MR pre
MOA buprenorphine
partial opioid receptor agonist - has both agonist and antagonist properties
it can precipitate withdrawal symptoms including pain in pt dependent on other opioids
true or false - effects of buprenorphine are only partially reversed by naloxone unlike other opioids
true
true or false - buprenorphine has abuse potential and can cause dependence
true
morphine vs buprenorphine - which one has longer duration of action
buprenorphine
