Pain

Question 1

What are the types of pain?

Answer 1

Acute, primary, secondary, chronic

Chronic pain lasts more than 12 weeks and is a complex phenomenon.

Question 2

What is neuropathic pain known for?

Answer 2

It can be harder to treat

Question 3

What characterizes chronic primary pain?

Answer 3

No underlying condition exists

Question 4

What characterizes secondary pain?

Answer 4

Pain has an underlying condition

Question 5

What common comorbidity is associated with chronic pain?

Answer 5

Depression

Question 6

What are the aims of treatment for chronic pain?

Answer 6

Reduce pain and reduce the impact on quality of life, mood, and function

Question 7

What is a non-drug treatment option for pain?

Answer 7

Exercise

Question 8

What does TENS stand for?

Answer 8

Transcutaneous Electrical Nerve Stimulation

Question 9

What types of drug treatments are available for pain?

Answer 9

Non-opioid, compound preparations, opioid analgesics

Question 10

What are examples of non-opioid analgesics?

Answer 10

Paracetamol, NSAIDs

Question 11

What do compound preparations sometimes contain?

Answer 11

Caffeine

Question 12

When are opioid analgesics used?

Answer 12

In moderate to severe pain

Question 13

What is a mild to moderate analgesic?

Answer 13

Codeine

Question 14

What are examples of moderate to severe analgesics?

Answer 14

Morphine, oxycodone

Question 15

When should opioid analgesics be utilized?

Answer 15

At the lowest effective dose

Question 16

What risks are associated with opioid analgesics?

Answer 16

Dependence and tolerance

Question 17

What are examples of adjuvant analgesics?

Answer 17

Antidepressants, antiepileptics, benzodiazepines, muscle relaxants

Question 18

What are suitable non-opioid drugs for pain in musculoskeletal conditions?

Answer 18

Paracetamol and aspirin, along with other NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medications that reduce inflammation and relieve pain.

Question 19

What type of pain are opioid analgesics primarily used for?

Answer 19

Severe pain, especially of visceral origin

Question 20

What medications are used in sickle cell disease?

Answer 20

Paracetamol, NSAIDs, codeine

Morphine is used in severe crises of sickle cell disease.

Question 21

What analgesic should be used with caution in sickle cell patients and why?

Answer 21

Pethidine, because it can cause seizures and has a short half-life

Question 22

What is the recommended approach for analgesics in dental patients?

Answer 22

Analgesics should be temporary as the underlying cause should be treated

Question 23

What is benzydamide hydrochloride used for in dental patients?

Answer 23

For oral mucosa

Question 24

What are the most effective analgesics for dental pain?

Answer 24

NSAIDs and paracetamol

Question 25

What should any analgesic given before a dental procedure have?

Answer 25

A low-risk bleed

Question 26

How long should post-operative treatment with ibuprofen and aspirin be continued?

Answer 26

24 to 72 hours after a dental procedure

Question 27

What can be used for period pain?

Answer 27

Oral contraceptives, paracetamol, and NSAIDs

Question 28

What are common uses for aspirin?

Answer 28

Headaches, temperature, musculoskeletal pain, period pain, anti-platelet properties

Question 29

When should NSAIDs be taken?

Answer 29

After food

Question 30

What is a severe interaction associated with aspirin?

Answer 30

Warfarin

Question 31

How does paracetamol compare to aspirin in terms of anti-inflammatory activity?

Answer 31

Paracetamol has no anti-inflammatory activity

Question 32

In which population is paracetamol considered better?

Answer 32

Elderly

Question 33

What can paracetamol cause in overdose?

Answer 33

Hepatic damage

Question 34

What conditions are NSAIDs particularly useful for?

Answer 34

Pain and inflammation, including secondary-borne tumors

Question 35

What do compound preparations contain?

Answer 35

Simple analgesics combined with opioids

Question 36

What side effects can a full dose of an opioid cause?

Answer 36

Nausea and vomiting, constipation, dependence, respiratory depression

Question 37

What is caffeine classified as and what effect can it have?

Answer 37

A weak stimulant that can lead to headaches

Question 38

Why is coproxamol not licensed?

Answer 38

Due to safety concerns and toxicity in overdose

Question 39

What is the most valuable strong opioid?

Answer 39

Morphine

Question 40

What are some effects of morphine?

Answer 40

Nausea, vomiting, euphoria, mental detachment

Question 41

How often is morphine used in severe pain in palliative care?

Answer 41

Every four hours

Question 42

What are the properties of buprenorphine?

Answer 42

Partially reversible, opioid agonist and antagonist properties

Question 43

What duration of action does buprenorphine have compared to morphine?

Answer 43

Longer duration of action (6-8 hours)

Question 44

What is the advantage of diamorphine over morphine?

Answer 44

Less nausea and hypotension, greater solubility, effective in smaller volumes

Question 45

How often should fentanyl patches be changed?

Answer 45

Every 72 hours

Question 46

What should be monitored with fentanyl use?

Answer 46

Risk of respiratory depression

Question 47

What are the two strengths of buprenorphine patches available?

Answer 47

5 microgram patches for 7 days and 35 microgram patches for 4 days

Question 48

What is an important counseling point for patients taking methadone?

Answer 48

About driving after taking methadone

Question 49

What is the use of oxycodone in pain management?

Answer 49

Second-line drug if morphine doesn't work or control pain

Question 50

What are the two methods of analgesia produced by tramadol?

Answer 50

Opioid effect and enhancement of serotogenic and adrenogenic pathways

Question 51

What side effects are less common with tramadol compared to typical opioids?

Answer 51

Fewer typical opioid side effects

Question 52

What is a key concern with codeine regarding its use?

Answer 52

Metabolism produces morphine

Question 53

Who cannot be sold codeine?

Answer 53

Under 12 years old, ultra-rapid metabolizers, breastfeeding, children with respiratory problems

Question 54

What is preferred for post-operative analgesia?

Answer 54

Morphine

Question 55

What can buprenorphine do to previously administered opioids?

Answer 55

Antagonize their analgesic effects

Question 56

What are key side effects of opioid use?

Answer 56

Respiratory depression, dependence, overdose

Question 57

What other side effects can occur with opioids?

Answer 57

Nausea and vomiting, constipation, dry mouth, hypogonadism, adrenal insufficiency

Question 58

What can opioids cause during pregnancy?

Answer 58

Respiratory depression

Question 59

What should be avoided to prevent opioid overdose?

Answer 59

Abrupt withdrawal

Question 60

What can heat and fever do to buprenorphine patches?

Answer 60

Increase absorption

Question 61

What should be done if a patient experiences breathing difficulties with buprenorphine patches?

Answer 61

Remove the patches

Question 62

What is the process for converting buprenorphine to fentanyl?

Answer 62

Convert to morphine first, then to fentanyl

Question 63

What are some causes of neuropathic pain?

Answer 63

Diabetic complications, chronic excessive alcohol intake, shingles, trigeminal neuralgia

Question 64

What medications are used to manage neuropathic pain?

Answer 64

Tricyclic antidepressants (amitriptyline, nortriptyline), gabapentin, tramadol, pregabalin

Question 65

What local treatments can benefit localized neuropathic pain?

Answer 65

Lidocaine plasters, capsaicin

Question 66

What is the treatment for trigeminal neuralgia?

Answer 66

Surgery and carbamazepine during acute stages

Question 67

What class of medications is also used for facial pain?

Answer 67

Tricyclic antidepressants