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Pain Relief Ladder / Analgesia - Summary Notes
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A comprehensive, yet concise summary of the Pain Relief Ladder in Medicine/ Surgery, presented in a colourful and digestible format. Includes all relevant information on the topic summarised, collated from multiple resources including lectures, textbooks, and guidelines. All my notes/ summaries use...

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  • May 31, 2023
  • 1
  • 2022/2023
  • Summary

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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.
·

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