Flashcards in GP Deck (17)
What is the analgesic ladder?
1 - non opioid (aspirin, paracetamol, NSAID) +/- adjuvant
2 - weak opioid (codeine) +/- non opioid +/- adjuvant
3 - strong opioid (morphine) +/- non opioid +/- adjuvant
How do opioids work?
block pain transmission by binding to receptors in the CNS
What can be used as non pharmalogical pain relief?
acupunctures, TENs machine, heat/ice, yoga, exercise, herbal, psychophysiological therapy, ablimen bust cycle, plan days, occupational therapy
What drugs can be given alongside the analgesic ladder?
gabapentin, pregabalin, antitriptyline
Side effects of opioids?
resp depression, nausea, constipation, drowsiness
Side effects of NSAIDs?
nausea, diarrhea, insomnia, abdominal pain, headaches, stomach ulcers
Side effects of COX-1?
stomach ulcers, intestinal bleeding (safer than NSAIDs for stomach)
What risks are there in pain killers?
watch if on alcohol or antidepressants, can gain tolerance, can gain dependence on the drug, get muscle pain and irritability
What is the QoL scale?
measures function for people with pain, developed by American Chronic Pain Association (ACPA) and should be completed when first seeking treatment, shows effect on work, social, exercise, household chores, mood and ranked 1-10, involves a pain diary or when, where, severity and relieving fatcors
Physiological effects of chronic pain?
reduced ability to work due to future uncertainty and balancing multiple roles, difficulty performing every day tasks, physical disability, problems with medication of side effects, interactions and dependence, becoming physically drained, stop doing things they enjoy
Psychological effects of pain?
marital and family problems, depression, increased suicidal thoughts and suicide attempts, sleep disturbance, helplessness, become irritable, short tempered, impatient, limit social contact, difficulty focusing on simple tasks, anxiety, loss of self esteem
Risk factors for depression?
low self esteem, being too dependent, self critical, pessimistic, traumatic event, bereavement, family history, being different (gay), abuse of alcohol and drugs, medications, chronic illness
Psychological symptoms of depression?
continuous low mood, feeling hopeless and helpless, feeling tearful, feeling guilt ridden, irritable, no motivation, lost interest, poor decision making, not enjoying life, feeling anxious, suicidal thoughts
Physical symptoms of depression?
moving or speaking more slowly, change in appetite or weight, constipation, unexplained aches and pains, lack of energy or loss of libido, changes to menstrual cycle, disturbed sleep
Social symptoms of depression?
not doing well at work, taking part in fewer activities, avoiding contact with friends, neglecting hobbies, difficulties in home and family life
How are chronic pain and depression linked?
they can exacerbate and make each other worse, and if you have one you are more likely to have the other, treating one can also help the other