Analgesic Medicines

• What are some risk factors for developing osteoarthritis?

  Hereditary factors, occupational factors, obesity, and joint injury
• What is the key pathogenetic event in osteoarthritis?

  Degeneration of the articular cartilage
• How does obesity relate to osteoarthritis?

  Increased load on joints can worsen osteoarthritis
• What happens to the cartilage in osteoarthritis?

  It wears out, causing bones to rub against each other
• How does the disease process of osteoarthritis progress?

  Cartilage continues to degenerate, leading to unique symptoms for each patient
• What is the impact of cartilage loss on symptom burden in osteoarthritis?

  The impact can vary considerably between patients
• What pharmacological management is recommended for osteoarthritis?

  • Topical NSAIDs for any joint
  • Oral NSAIDs if topical is ineffective
  • Gastroprotective agents with oral NSAIDs
  • Avoid routine use of paracetamol or weak opioids
• What is the first step in the analgesic ladder for pain management?

  Paracetamol or non-steroidal anti-inflammatory drugs.
• What are the two main groups of analgesic medicines?

  1. Non-narcotic analgesics (e.g., paracetamol, NSAIDs)
  2. Opiate (opioid) analgesics
• What is the mechanism of action of NSAIDs?

  They block cyclo-oxygenase-1 (COX-1), reducing gastroprotective prostaglandins.
• What is the purpose of the analgesic ladder?

  • Establish rational use of analgesics
  • Sequential use of analgesic drugs
• What are the side effects of NSAIDs?

  • Gastrointestinal toxicity
  • Renal toxicity
  • Liver toxicity
  • Cardiovascular toxicity
• What is the role of gastroprotective agents when using oral NSAIDs?

  • Protect the stomach lining
  • Reduce risk of gastrointestinal side effects
• What are analgesic medicines used for?

  To alleviate pain
• What are opiates derived from?

  The opium poppy
• What is the purpose of the "Analgesic ladder"?

  To establish the rational use of analgesics
• For what type of pain was the "Analgesic ladder" first developed?

  Cancer pain
• What are the three steps of the analgesic ladder?

  1. Paracetamol or NSAIDs for mild pain
  2. Opioids for mild to moderate pain (e.g., codeine, tramadol)
  3. Opioids for moderate to severe pain (e.g., morphine, fentanyl)
• What should be done if pain persists or increases after taking the first step of the analgesic ladder?

  Proceed to the next step of opioids for mild to moderate pain
• What is recommended regarding the timing of analgesic doses?

  Keep the doses regular and do not let pain get severe before taking the next dose
• What are the two main groups of analgesic medicines?

  Non-narcotic analgesics and opiate analgesics
• What are examples of non-narcotic analgesics?

  • Paracetamol
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
• What is an example of an opiate analgesic?

  Morphine
• Why should NSAIDs not be used by patients with a history of stomach problems?

  They block COX-1, reducing gastroprotective prostaglandins