Notes for: Central nervous systemLast edited [10/12/2021 11:31:41]
‘Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness’ recommends that patients at risk of suicide, including all patients with a recent history of self-harm, who are treated with psychotropic drugs should receive modern, less toxic drugs and/or supplies lasting no more than 2 weeks.
Notes for: AnalgesicsLast edited [11/08/2011 13:16:48]
1. It is important that analgesics are given regularly for chronic pain as they are more effective in preventing than relieving pain. Adequate doses of non-opioids given regularly will often make the use of opioids unnecessary.
2. Analgesics have a 'dose ceiling' with regard to efficacy, and the variable side-effect profile up to the maximum useful dose will influence the choice of a particular analgesic.
For advice on pain relief in palliative care see BNF Prescribing in Palliative Care, Joint Formulary Palliative Care Guidelines (chapter 16) and contact the medical staff at:
Mount Edgcumbe Hospice - 01726 65711
St Julia's Hospice - 01736 759070
St Luke's Hospice - 01752 401172
Guidance on other supportive treatments may be obtained from the Pain Relief Clinic at Royal Cornwall Hospital Trust - 01872 252792
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Notes for: Treatment Of Acute MigraineLast edited [12/12/2012 16:19:36]
1. NICE has issued guidance on management of headache
2. Initial treatment of migraine should be with simple analgesics such as aspirin, paracetamol or NSAIDs. Since peristalsis is often reduced in migraine attacks, dispersible preparations should be given.
3. Analgesics may be given with or without an antiemetic such as metoclopramide.
4. 5HT1 agonists (triptans) should be reserved for patients who do not respond to these simple measures.
5. Triptans must be used appropriately at the lowest effective dose. They are intended for single use only. Experience has shown that problems may occur if they are used more frequently than this. Eg to prevent 'triptan-misuse headache' the drug should not be used, on average, more than two days a week.
6. NSAIDs may be useful, but there is little evidence that any one is any better than any other.