Question

How would you determine which of the following pain medication(s) to give a patient who:

Has just had breast augmentation surgery?

Has chronic neck and back pain from a car accident?

Has terminal metastatic cancer?

Had their wisdom teeth removed?

Suffers from migraines?

Has rheumatoid arthritis?

Use the opioid conversion table found in your text, and the following chart to assist you:

Analgesic	Strength	Equivalent dose
	(relative)	(10 mg Oral morphine)
Aspirin (non-opioid)	1/360	3600 mg
Ibuprofen (NSAID, non-opioid)	1/222	2220 mg
Naproxen (NSAID, non-opioid)	1/138	1380 mg
Dextropropoxyphene	1/13 to 1/20	130–200 mg
Codeine	1/10	180 mg (PO)
Tramadol	1/10	>200 mg
Pethidine (meperidine hydrochloride)	1/3	30 mg SC/IM/IV, 300 mg PO
Hydrocodone	1	10 mg
Morphine (oral)	(1)	(10 mg) (30 mg PO)
Oxycodone	1.5	6.67 mg
Morphine (IV/IM)	3	3.33 mg
Methadone (acute)	3–4	2.5–3.33 mg
Diamorphine (Heroin; IV/IM)	4–5	2–2.5 mg
Hydromorphone	5	1.5 mg SC/IV/IM, 7.5 mg PO
Oxymorphone	7	10 mg PO, 1 mg IV
Methadone (chronic)	2.5 to 5	3.33 mg
Fentanyl	50–100	0.1 mg (100 mcg) IM/IV

2

Answer 1

• In breast augmentation surgery the anlgesics like Ibuprofen are admiistered
• For chronic neck and back pain out of car accidents Hydrocode or oxycodone can be given because they block brains ability to feel pain and ensure comfort
• For terminal metastatic cancer the common drug used to alleviate pain is morphine is gold standard the others are Hydromorphane,fentanyl or oxycodone
• For wisdom tooth removal Ibuprofen is the best pain killer
• For rheumatoid arthritis ibuprofen can be used then aspirin helps to reduce swelling
• For migrane pain killers like Naproxen