Pain Management

Question 1

What is allodynia?

Answer 1

Pain from a stimulus that is not normally painful

Question 2

What is hyperalgesia?

Answer 2

Pain that is beyond what is expected from a painful stimulus

Question 3

Descibre the WHO treatment ladder for pain relief?

Answer 3

1. Non-opiods (paracetamol, NSAIDs )
2. Weak opiods (tramadol, codeine)
3. Strong opiods (morphine, heroin)

Question 4

Name three topical analgesics

Answer 4

Capsaicin

Lidocaine 5% plaster

Camphor

Question 5

How do NSAIDs fight pain? Give examples of drugs and side effects.

Answer 5

Inhibit COX1 to decrease prostaglandin synthesis

Examples: Aspirin, ibuprofen

Side effects: GI irritation, renal toxicity

Question 6

How does paracetamol work? List a side effect

Answer 6

Inhibits prostaglandin synthesis

Risk of liver toxicity

Question 7

How do opioids work? Give examples of drugs and side effects

Answer 7

Affect descending pathways to reduce pain perception and transmission. Opioids act mainly by activation of μ-receptors (opioid receptors).

Examples: Tramadol, codeine, morphine

Side effects: Nausea, vomiting, constipation, dizziness

Question 8

Anti-depressants (amitriptyline) can be used for pain. How do they work? List some side effects

Answer 8

Inhibit noradrenaline and 5-HT uptake

Side effects: Constipation, dry mouth, arrhythmias, insomnia

Question 9

What can be given for opioid toxicity?

Answer 9

μ-receptor ANTAGONISTS such as naloxone.

Question 10

What drugs would be used for neuropathic pain?

Answer 10

Amitriptyline (anti-depressant), gabapentin and pregabalin (antiepileptics)