1) which step on the pain ladder is tramadol? a) 1 b) 2 c) 3 d) 4 2) which step on the pain ladder is ibuprofen? a) 1 b) 2 c) 3 d) 4 3) codeine a) dose = 10mg tds b) a strong opiate c) causes diarrhoea d) a weak opiate 4) amitriptyline a) SSRI antidepressant b) good for nerve pain / chronic pain c) causes hypersalivation d) causes insomnia 5) paracetamol a) reduces fever b) causes renal failure c) safe in overdose d) can be applied topically 6) ibuprofen a) impairs liver function b) use with caution in asthmatics c) a PPI alongside is mandatory d) of little benefit in arthritis e) cannot give alongside paracetamol 7) tramadol a) strong opiate b) can give alongside codeine c) is a controlled drug d) step 3 of the pain ladder e) usually given via a patch 8) morphine a) good for chronic pain b) not addictive c) given PO / IV / PR  d) available in a patch 9) TENS machine a) inserted surgically b) contraindicated in pregnancy c) work using pain gate theory d) must be prescribed 10) slow release morphine a) given three times daily b) used use instead of short acting preparations c) may cause nausea d) hard to overdose on

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