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Pharmacy Professionalism & practice > RTS Pain - musculoskeletal conditions > Flashcards

RTS Pain - musculoskeletal conditions Flashcards

1
Q

what are the 3 different types of headache?

A

Tension
migraine
cluster

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2
Q

describe the symptoms of a tension headache

A

pain - mild to moderate
generalised dull ache
band around head or pressure on head
bilateral

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3
Q

describe the symptoms of a migraine headache

A 
mild- moderate severe pain - throbbing, worse when moving
unilateral 
blind spots
flashing lights 
photophobia
nausea
vomiting
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4
Q

describe the symptoms of a cluster headache

A

intense pain
unilateral
orbital pain
runny nose/eyes the same side as the pain

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5
Q

what are the common patient groups for each type of headache?

A

tension - most age groups
migraine - women more likely than men, (if first one and >50 refer)
Cluster- men more likely

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6
Q

how long are each type of headache generally?

A

tension - self limiting, can get worse as day goes on(rest helps)
migraine - lasts hours > 3 days, recurring
Cluster - 10 mins - 3 hours, same time of day and recurring

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7
Q

What types of medication could trigger headaches?

A

Nitrates (open up blood vessels)
contraceptive pill
HRT
overuse of painkillers

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8
Q

what sort of things can trigger migraines?

A

foods, activity, situation, stress, caffeine, cheese alcohol

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9
Q

what are the common causes of headaches?

A

stress, dehydration, fatigue, infection, eye strain, toothache, period, ears

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10
Q

name the locations of each type of headache

A

tension - back of head
migraine - one sided
cluster - eye area

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11
Q

red flags associated with headaches

A 
ongoing severe pain lasting >4 hours
sudden onset
recent trauma
suspected depression
cluster headache 
severe eye pain
vomiting,confusion, malaise
migraine occurring for first time aged >50
treatment fail
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12
Q

what is dental pain?

A 
Intense throbbing pain in tooth or gum that may come suddenly and gradually get worse-
pain can spread to ear/jaw 
worse when laying down
redness/swelling face
red gums 
bad breath
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13
Q

symptomatic relief for dental pain

A

ENCOURAGE TO SEE DENTIST ASAP
Oral analgesics - 1st line - NSAIDS if no CI, then paracetamol or combination

Can also have a combination containing a mild opioid e.g co codamol - neurofen or dihydrocodeine - paramol

Other options-

  • orajel - benzocaine 2-% w/w - numbs, anaesthetic
  • anbesol liquid or gel - lidocaine hydrochloride 0.9%, chlorocresol 0.1%
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14
Q

Differentiate between acute and chronic pain

A

Acute:

  • provoked by a disease or injury
  • associated with muscle spasm/nerve activation
  • self limiting
  • serves a biological purpose

Chronic:

  • Considered a disease state
  • can arise from psychological state
  • outlasts the normal time of healing
  • serves no biological purpose
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15
Q

Define - sprain, strain, bruising

A

Sprain - overstretching or twisting ligaments
Strain - muscle or tendon injury with swelling & pain
Bruising - damage to capillaries causing blood leakage

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16
Q

what are the 3 phases of the healing process?

A
  1. inflammation - lasting approx 72 hours - PRICE
  2. tissue repair - lasts up to6 weeks
  3. Change of scar tissue to a more ordered arrangement
17
Q

What things should be considered when taking a patient history for musculoskeletal conditions?

A

improvement In 72 hours?
what caused it?
Has it happened before? previous injury? did it heal?
Drug history - recent new meds? e.g statins side effects are muscle pain, or blood pressure medications that lower BP light headed?

18
Q

symptomatic treatment of musculoskeletal and what not to be used?

A
  1. oral analgesics - para with topical NSAID
  2. NSAIDS - topical analgesics BUT do not use topical NSAID with oral NSAID
    DO not use aspirin
19
Q

why should aspirin not be used in treatment of musculoskeletal ?

A

it affects clotting and bruising as it causes blood to become runny and pool in the area affected

20
Q

what is the pain ladder for musculoskeletal?

A

mild /mod pain 2-5/10 - non opioids e.g paracetamol /NSAID

5-8/10 - mild opioids e.g codeine, dihydrocodeine & cocodamol

8-10 - strong opioids e.g morphine

21
Q

In the first 72 hours of injury. - what should be done?

A

PRICE and HARM

22
Q

what is PRICE?

A

p - protect from further damage e.g. support
r - rest
I- ice - reduces swelling and bruising - 15 mins every 2-3 hours, don’t apply directly to skin
c - compress- elastic bandage, limit swelling, but not in sleep
e -elavate above heart level and support

23
Q

what is HARM?

A

Do not do these -
H- heat - this increases blood flow and swelling
A- alcohol - increases bleeding and swelling
R- running - further damage
M- massage - swelling & bleeding as it breaks BV

24
Q

what is rubefa and give examples?

A

causes warming of skin via vasodilation
masks the perception of heat
e.g
Methyl salicylate, nicrotinates, menthol, camphor, turpentine, capsaicin

25
Q

give 5 examples of red flag symptoms in injury

A 
severe and prolonged pain
unable to bare weight 
head injury 
fever, chills, malaise, passing out - infection signs 
numbness
26
Q

what medications can cause bruising?

A

warfarin
NSAIDS
steroids
carbimazole

27
Q

symptomatic treatment of bruising

A
  1. heparinoid - disperse the oedema
  2. arnica - herbal
  3. witch hazel - astringent and anti inflammatory
28
Q

why must we detect where the lower back pain specifically is?

A

If low and radiating to arm/side. - heart attack

near kidneys-could be a water infection especially if they are going to toilet a lot and urine is dark

29
Q

treatments of lower back pain

A

Oral - NSAIDS, - ibuprofen, diclofenac
Para

Topical: NSAID gels or creams if not oral, heat, rubefacients

30
Q

treatments to help with rheumatism/arthritis OTC?

A
  • glucosamine sulphate - anti inflammatory and help cartilage
  • Chondroitin - in cartilage, to retain water

NICE guidance suggests not offering these for management as many studies show no improvement

Pharmacy Professionalism & practice (25 decks)

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