An assignment given by a person named Hassan from England. He gets his work without paying and cheats his university.
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Non opioids for
pain
c,d,g
|
|
Weak opioids
for persisting pain
a,f
|
|
Strong opioids
for severe pain
b,e
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Look at the following
ladder for pain management:
1)Which of the
following drugs would you place on the bottom rung of the ladder (non opioids
for pain)? (P9)
a)
Codeine
b)
Oxycodone
c)
Ibuprofen
d) Paracetamol
e)
Morphine
f)
Dihydrocodeine
g)
Aspirin
2)Which of the
following drugs would you place on the middle rung of the ladder (weak opioids
for pain)? (P9)
a)
Codeine
b)
Oxycodone
c)
Ibuprofen
d) Paracetamol
e)
Morphine
f)
Dihydrocodeine
g)
Aspirin
3)Which of the
following drugs would you place on the top rung of the ladder (strong opioids
for severe pain)? (P9)
a)
Codeine
b)
Oxycodone
c)
Ibuprofen
d) Paracetamol
e)
Morphine
f)
Dihydrocodeine
g)
Aspirin
For
questions 4-7, put ticks in the appropriate boxes to show the actions of the
following analgesics: (P9)
Analgesic
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Reduces pain
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Reduces fever
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Reduces swelling
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Thins the blood
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Q4) Aspirin
|
ü
|
ü
|
||
Q5) Ibuprofen
|
ü
|
ü
|
||
Q6) Codeine
|
ü
|
|||
Q7) Paracetamol
|
ü
|
8) Which of the
following analgesics commonly causes drowsiness? (P10)
a)
Aspirin
b)
Ibuprofen
c) Codeine
d) Paracetamol
9) Which of the
following analgesics might cause gastro intestinal bleeding? (P10)
a) Aspirin
b)
Ibuprofen
c)
Codeine
d) Paracetamol
10) Which of the
following analgesics might trigger asthma? (P10)
a) Aspirin
b)
Ibuprofen
c)
Codeine
d) Paracetamol
11) An elderly
patient asks about taking aspirin for her headache. What would you recommend
and why? (P11)
Aspirin may
cause bleeding in the small intestine, stomach, and brain in
elder people; therefore the patient would be recommended to avoid prolonging
the aspirin use. The reason is because of the fragility of blood vessel in old
age. And thus, if any such complication develops, he should immediately stop
taking aspirin and report about it.
12) A patient is
suffering from mild to moderate pain following a back operation. What analgesic
and dose could you recommend to this patient? (P9)
Codeine or dihydrocodeine would be prescribed for mild
to moderate pain for this patient. Either of the analgesic would be given in a
dose of 60 mg.
13) List 3 possible
side effects of the analgesic chosen in your previous answer and explain
anything you would need to counsel the patient about (P10 and P11)
The side effects of dihydrocodeine include:
·
Constipation
·
Drowsiness
·
Dry mouth
In order to
avoid these side effects, a patient will counsel to use it for a short time
period because if used for a long duration, dependence may occur.
14) What drug and dose could the patient be
stepped up to if the initial analgesic does not control the pain? (P9)
In case of initial analgesic fails to provide a relief, weak
opioids are administered and if it still fails then strong opioids are given.
15)
Why might temazepam be given as a pre-medication before an operation?
a)
For legal reasons
b)
For pain relief
c) To
decrease anxiety, alleviate fear and produce a state of calmness.
d)
To produce respiratory depression
16)
Which of the following are often used in intravenous general anaesthesia?
[select all that apply]
a) Nitrous oxide
b) Thiopental
sodium
c) Benzocaine
d) Propofol
17) A Patient is
undergoing surgery. As part of the anaesthetic they were administered with 5mg
of Alfentanil over 10 minutes followed by a maintenance dose of 50mcg/minute by
intravenous infusion.
What is the purpose
of the drug?
a) To
prevent salivary excretions
b) Muscle
relaxant
c) Opioid analgesic for pain
relief
d)
Inductions and maintenance of anaesthesia
18) The patient was also given 5mg of
Mivacurium followed by a maintenance dose of 700mcg/minute by intravenous
infusion.
What is the purpose of the drug?
a) Muscle relaxant
b)
Inductions and maintenance of anaesthesia
c) To
prevent salivary excretions
d) Opioid
analgesic for pain relief
19) Why are combinations of drugs used in
general anaesthesia?
Propofol, Morphine,
halothane or nitric oxide, succinylcholine, etc are some of the drugs
combination used in general anaesthesia.
20)
Local anaesthesia involves:
a)
Putting the patient into an unconscious state - strong analgesics and paralysis
agents are also used for major surgery
b)
The numbing of a small area of the body but the patient is put into an
unconscious state
c)
The numbing of a small area of the body in which the patient remains conscious
– strong analgesics and paralysis agents are used for safety
d) The
numbing of a small area of the body and the patient remains conscious for minor
surgery
21) Which one of the following is
false regarding local anaesthesia?
a) The patient does not have to spend
a night in hospital
b)
The recovery time will be greater than general having a general anaesthetic
c) The individual does not have to
undergo treatment with several drugs
d) They can be given through various
routes
22)
Topical anaesthetics are (select those that apply):
a)
Invasive
b)
Used for simple pain relief
c)
Available OTC
d) Used during childbirth and major
surgery
23) An epidural anaesthetic (select
those that apply):
a)
Provides complete pain relief without making you feel drowsy
b) Is used during childbirth and major
surgery
c) Causes the patient to fall
unconscious
d)
Is suitable for patients with back problems
24) Discuss the difference between
topical and epidural anaesthesia. Include when they are used, how they are
administered and give two advantages and two disadvantages of both.
Epidural anaesthesia is
basically administered in order to keep offer anaesthesia for several major
surgeries of the limbs, abdominal and hips region. This anaesthesia is given at
the epidural space of the spinal cord in the back area. On the other hand,
local anaesthesias can be given at a variety of places for only minor
procedures. The local anaesthesia provides regional nerve block.
Advantages
Epidural
anaesthesia
1)
Epidural anaesthesia is required in a very less dose
compared to general anaesthesia.
2)
It serves as an excellent way to manage labour pain and delivery.
Local
Anaesthesia
1)
It has an ability to provide numbness of a particular region of
the body without affecting the level of consciousness of a patient.
2)
Patients recover faster.
Disadvantages
Epidural
anaesthesia
1)
Headache may occur in several patients who receive this type of
anaesthesia.
2)
It may lower the blood pressure.
Local
Anaesthesia
1)
Sometimes, local anaesthesia takes time to produce anaesthesia,
like it may take up to 30 minutes in numbing the area where it is administered.
2)
It may not prove to be effective occasionally and thus may need
additional anesthesia.
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