Pain Flashcards
(55 cards)
Definition of primary pain
No obvious cause or pain is out of proportion to any obvious injury/disease
Definition of secondary pain
Caused by an underlying condition
How often should pain relief for chronic pain be reviewed?
At least annually
Definition of chronic pain
pain >12 weeks
Why are fixed dose combination products containing low-dose opioids not used in chronic pain?
Increase side effect burden without offering additional pain relief
Describe the licensing for opioid use in pain
To be used short-medium term for when other therapies have been insufficient in chronic non-malignant pain
What is the paracetamol dosing in a 6-7 year old child?
240- 250mg every 4-6 hours. Max 4 doses in 24 hours
What is the paracetamol dosing in a neonate 28-32 weeks corrected gestational age?
20mg/kg for 1 dose. Then 10-15mg/kg every 8-12 hours. Max 30mg/kg in 24 hours
What is the paracetamol dosing in a neonate 32+ weeks corrected gestational age?
20mg/kg for 1 dose. Then 10-15mg/kg every 6-8 hours. Max 60mg/kg in 24 hours
What is the paracetamol dosing in a child aged 1-2 months?
30-60mg every 8 hours. Max 60mg/kg in 24 hours
What is the paracetamol dosing in a child aged 3-5 months?
60mg every 4-6 hours. Maximum 4 times daily
What dose of opioids (morphine equivalent) requires a specialist pain referral?
> 90mg OD
Which NSAID has the weakest anti-inflammatory properties?
Ibuprofen
Which NSAIDs are associated with a particularly increased thrombotic risk?
High dose ibuprofen and diclofenac, selective COX-2 inhibitors
Which NSAID is licensed for pain associated with acute gout?
Etorcoxib
Which NSAID has the highest risk of GI side effects?
Piroxicam
What is Celecoxib licensed for?
Licensed for rheumatoid arthritis, ankylosing spondylitis and osteoarthritis
Which of the NSAIDs is superior to that of Naproxen but has a high SE profile including GI disturbances, dizziness and headaches?
Indomethacin
Which class of NSAIDs have a higher risk of GI side effects?
Non-selective COX-2 inhibitors
Which NSAID is associated with diarrhoea and haemolytic anaemia?
Mefenamic acid
Which NSAID is associated with a lower thrombotic risk than others?
Naproxen
From what point of pregnancy is it advised NSAIDs aren’t used?
Should be avoided from 20 weeks
Which trimester are NSAIDs completely contra-indicated in?
3rd trimester (week 28)
What is a fundoscopy?
Investigation that looks at the optic nerve and retina (back of eye)
