PAIN MANAGEMENT QUESTIONS

1. Looking at the table below, select the combination that is correct.

Weak Opioid Strong Opioid Adjuvant

A. Codeine Paracetamol Duloxetine
B. Tramadol Morphine Amitriptyline
C. Oxycodone Tramadol Diazepam
D. Tramadol Morphine Galantamine

2. Patient A was receiving PO Oxycontin 20 mg BD and PO Oxynorm 5 mg Q4H

prn for his cancer pain. Yesterday, his pain worsened and his medications were
adjusted to PO Oxycontin 30 mg BD and PO Oxynorm 5 mg Q4H prn. Today,
the patient looked very drowsy. He was not arousable even after calling his
names a few times. His Glasgow Coma Scale score was calculated to 5 and his
oxygen saturation fell to 78%. What would be part of the appropriate
management of the patient?

i. Temporarily discontinue all orders for opioid analgesics

ii. Administer IV naloxone to reverse the effects of the opioid
analgesics
iii. Initiate oxygen supplementation
iv. Administer IV diazepam in case the patient develops seizures

A. i and iv
B. ii and iii
C. ii, iii and iv
D. All of the above

3. Which of the following drugs is not recommended for the treatment of neuropathic
pain?

a. Pregabalin
b. Duloxetine
c. Galantamine
d. Nortriptyline