Answer to Question 1
B
Administering analgesics to treat cancer-related pain requires applying principles different from those used to treat acute pain. The WHO (1990) has recommended a three-step approach to managing cancer pain. Therapy begins with NSAIDs and/or adjuvants and progresses to strong opioids if pain persists. Side effects of opioids such as nausea and constipation are treated aggressively so patients are able to continue using them. Patients usually become tolerant to their side effects, with the exception of constipation. For patients with cancer the aim of drug therapy is to anticipate and prevent or minimize pain. Therefore it is necessary to give required analgesic dosages regularly, even when pain subsides. Regular administration maintains blood levels for ongoing pain control.
Answer to Question 2
B
The most common method of pain relief is analgesics. There are three types of analgesics: (1) nonopioids, including acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs); (2) opioids (traditionally called narcotics); and (3) adjuvant or coanalgesics, a variety of medications that enhance analgesics or analgesic properties that were originally unknown. Nonselective NSAIDs such as aspirin and ibuprofen provide relief for mild-to-moderate acute intermittent pain such as that from headache or muscle strain.
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Mechanisms of pain at the nociceptor level.