Pain and Analgesia

Study Notes

WWHAM is a questioning method used to gather information about a patient’s pain experience.
Pain is defined as an unpleasant sensory and emotional experience caused by actual or potential tissue damage.
Analgesia refers to drugs used to relieve pain.
Acute pain is relatively short-lived and often associated with an injury or illness.
Chronic pain persists for an extended period (at least 3 months) and may be related to underlying medical conditions.
Somatic pain originates from bone, muscle, and connective tissue.
Visceral pain stems from internal organs, such as the stomach or intestines.
Neuropathic pain is caused by damage to the nervous system.
Breakthrough pain is a sudden spike in pain that occurs even when someone is taking medication for chronic pain.
Idiopathic pain has an unknown cause.

Indication: Paracetamol is an analgesic (pain reliever) and antipyretic (fever reducer), but it is not an anti-inflammatory agent.
Mode of action: Paracetamol is a mild inhibitor of prostaglandin synthesis.
Adult Dose: 500mg to 1g up to four times daily (qds) for adults (16+), with a maximum dose of 4g in 24 hours.
Child Dose: 500mg up to four times daily for children (10-15 years old), with a maximum dose of 2g in 24 hours.
Baby/Young Child Dose: Consult a weight-based dosing chart or product information for infants (2 months or older).
Side-effects: Side effects are not common with paracetamol.
Overdose: Overdose can lead to liver damage and can be fatal.

Sale restrictions are in place for paracetamol:
- Non-pharmacy sales are limited to 12 tablets or less.
- Pharmacies can sell up to 24 tablets.
- Customers requesting more than 24 tablets must be referred to the pharmacist, and a maximum of 50 tablets (or two packs of 48) can be supplied.
- Quantities exceeding 50 tablets require a prescription.

Adult formulations: Generic formulations of paracetamol are readily available in various forms, including tablets, capsules, granules, and oral suspensions.
Paediatric formulations: Paracetamol formulations specifically designed for children are also available.

Calpol 120mg/5ml Infant Oral Suspension: This formulation is intended for infants and is available in a suspension for easy administration. Refer to the product information or www.hpra.ie for details.
Calpol Six Plus 250mg: This formulation is intended for children who are six years of age and older and is available in a suspension for easy administration.