Week 7 Category 3
Activity 1
Answer the following questions:
a. What does Panadeine forte® contain?
Paracetamol 500mg & codeine 30mg
b. Are there any precautions that need to be taken when taking this medicine?
• Addiction - codeine is an opioid
• Hypersensitivity/allergy to paracetamol and codeine
• Taking other medication containing paracetamol (i.e. cold & flu tabs)
• Codeine contraindicated during pregnancy
c. What is the difference between Panadeine® and Panadeine forte ®?
Panadeine contains 8mg codeine, panadeine forte contains 30mg codeine.
Paracetamol content is the same in both
d. What is the difference between Nurofen Plus® and Panadeine forte®?
Nurofen plus is ibuprofen 200mg and codeine 12.8mg; panadeine forte is paracetamol 500mg
and codeine 30mg. i.e. nurofen is ibuprofen (anti-inflammatory) plus codeine, panadeine is
paracetamol (analgesic) plus codeine
Activity 2
Answer the following questions:
1. Outline, in broad terms, the relationship between anxiety and pain.
Pain and anxiety often co-exist with each other. Anxiety is a state of the autonomic system,
which causes a heightened sense of alarm. The state of alarm is commonly 'set off' by the
possibility of dangerous things happening. Since pain is a danger signal, pain naturally causes
the body to initiate the 'fight or flight' response.
In acute pain, this can be useful, however in chronic pain, the anxiety is acerbated and
becomes chronic as well. The chronic anxiety then results in a chronic focus on pain and
suffering.
2. Could his anxiety influence the therapeutic outcome of your management of his knee pain?
Yes. Since the nervous system is in a persistent state of activity, it can cause the patient to
focus on pain and their suffering, which in turn results in more pain. To adequately treat the
patients knee, you would also need to address the underlying anxiety. This could be done by
educating and guiding yourself, or referring to a professional (i.e. psychiatrist) if deemed
necessary.
3. He asks you about your opinion regarding medications to help his anxiety.
a. What types of drugs are used in the treatment of anxiety disorders?
Commonly the following medications are used to treat anxiety:
o Citalopram
o Fluoxetine
o Sertraline
o Paroxetine
o Escitalopram
o Fluvoxamine
b. What are some of the problems that may occur with their use?
Common side effects include nausea, headaches, sweating, dizziness, agitation, weight
gain, blurry vision, dry mouth and sexual difficulties. With some anxiety medications
addiction can be a common side affect, as well as cognitive decline
c. What other type of management strategies are available in the treatment of anxiety?
The following are some alternative therapies for managing anxiety without medication
o Exercise regularly - increases serotonin levels
o Eat a proper & well balanced diet - there is evidence vitamin & mineral
deficiencies can contribute to anxiety
o Increase omega-3
o Meditate
o Yoga
o Massage therapy
o Avoid alcohol & drugs
o Counselling
d. Name some of the questionnaires/inventories used in the assessment of a patient’s
anxiety.
o GAD7 anxiety test
o K10 test
o Anxiety symptoms questionnaire (ASQ)
Activity 3
Discuss in your groups, the possible ways you could approach his stress issues. How would
you handle this patient in your practice. Thinking about your reflective process is this a good
situation to think about onward referral is this patient best treated with a group / team
approach?
Upload recording / video or discussion points from your group discussion.
• Believe the best approach is to refer him to a specialist and have a 'team approach'
• Some red flags include
o Enquiring about medications
o Stressed in all aspects of life (school, home, AFL)
o Feels pressured to perform well in AFL & school/university
o Worried his injury will ruin his AFL plan - wants to hide the injury
• Referring would allow him to receive the best care for his stress/anxiety/depression,
which would assist with his healing time and recovery of his knee injury.
