Pain Ladder
less pain
hore
Non-Opiods:e.g. Paracetamol, NSAIDs.
non-opiod stays throughoutladder.
Weak O piods:e.g. Codeine.
strong Opiods:e.g. morphine.
pain
·
don'tforget to prescribe some
analgesia as PRN.
Drugs
Paracetamol:
analgesic and antipyretic, butnot anti-inflammatory.
used in all
stages of pain ladder, can be combined with Ibuprofen.
·
don't
give multigle drugs containing paracetamol in case of overdose
·
(e.g. Panadol, Lemsip, Flutablets, co-codamol).
NSAIDs: anti-inflammatory leads to
analgesic effect.
e.g. Ibuprofen, Naproxen, Aspirin, Diclofenac A
prosto
Mechanism:inhibit gland in synthetase.
·
·
Contraindications:Asthma, GORD/Gastritis, Antiplatelettreatment/Clotting disorder, HI.
Aspirin to be used in
not children due to Reye's Syndrome.
Side Effects:Gl issues take with 991, bronchospasm, increased bleeding risk.
· -
Weak Opioids:acton CNS, no
anti-inflammatory effect.
e.g. codeine often
-
combined with Paracetamol (Co-codamol)/Ibuprofen (Codafen).
not suitable for use,due to liver damage and dependence.
long-term
·
Contraindications:children and breastfeeding
·
women.
Side Effects:slows Gl
motility and constipation. Opioid Overdose:
·
causes
symptoms: PinpointPupils
· -
-
Unconciousness
Resp Depression
-
strong opioids: act CNS, anti-inflammatory effect. Naloxone is opiate antagonist,
·
on no
e.g. Morphine, Fentanyl. given to treat opioid overdose.
can lead to dependence.
·
·
Mechanism:crosses BBB and acts on Mr and Kappa receptors in CNS.
Contraindications:Hypotension, Respiratory Failure, Liver failure. Depression.
·
Side Effects:slows Gl
motility and causes constipation. Type 2 Resp Failure.
·
Other
Drugs:can be used as adjuvants alongside pain ladder, and can have
analgesic effect.
Amitriptyline:antidepressant increases serotonin. I useful in
· -
Diazepam:anxiolytic increases GABAAbinding.
·
I neuralgia, neuropathy
-
gain.
Gabapentin, Carbamazepine:antiepilectic.
·
less pain
hore
Non-Opiods:e.g. Paracetamol, NSAIDs.
non-opiod stays throughoutladder.
Weak O piods:e.g. Codeine.
strong Opiods:e.g. morphine.
pain
·
don'tforget to prescribe some
analgesia as PRN.
Drugs
Paracetamol:
analgesic and antipyretic, butnot anti-inflammatory.
used in all
stages of pain ladder, can be combined with Ibuprofen.
·
don't
give multigle drugs containing paracetamol in case of overdose
·
(e.g. Panadol, Lemsip, Flutablets, co-codamol).
NSAIDs: anti-inflammatory leads to
analgesic effect.
e.g. Ibuprofen, Naproxen, Aspirin, Diclofenac A
prosto
Mechanism:inhibit gland in synthetase.
·
·
Contraindications:Asthma, GORD/Gastritis, Antiplatelettreatment/Clotting disorder, HI.
Aspirin to be used in
not children due to Reye's Syndrome.
Side Effects:Gl issues take with 991, bronchospasm, increased bleeding risk.
· -
Weak Opioids:acton CNS, no
anti-inflammatory effect.
e.g. codeine often
-
combined with Paracetamol (Co-codamol)/Ibuprofen (Codafen).
not suitable for use,due to liver damage and dependence.
long-term
·
Contraindications:children and breastfeeding
·
women.
Side Effects:slows Gl
motility and constipation. Opioid Overdose:
·
causes
symptoms: PinpointPupils
· -
-
Unconciousness
Resp Depression
-
strong opioids: act CNS, anti-inflammatory effect. Naloxone is opiate antagonist,
·
on no
e.g. Morphine, Fentanyl. given to treat opioid overdose.
can lead to dependence.
·
·
Mechanism:crosses BBB and acts on Mr and Kappa receptors in CNS.
Contraindications:Hypotension, Respiratory Failure, Liver failure. Depression.
·
Side Effects:slows Gl
motility and causes constipation. Type 2 Resp Failure.
·
Other
Drugs:can be used as adjuvants alongside pain ladder, and can have
analgesic effect.
Amitriptyline:antidepressant increases serotonin. I useful in
· -
Diazepam:anxiolytic increases GABAAbinding.
·
I neuralgia, neuropathy
-
gain.
Gabapentin, Carbamazepine:antiepilectic.
·
